• Alex Piszker, Jennifer Goodrich, Tracy Koehler, and Ryan Offman.
• Department of Emergency Medicine, Trinity Health-Muskegon, Muskegon, Michigan; Department of Osteopathic Medical Specialties, Michigan State University, College of Osteopathic Medicine, East Lansing, Michigan. Electronic address: Alexander.Piszker@trinity-health.org.
• J Emerg Med. 2024 Oct 1; 67 (4): e351e356e351-e356.

BackgroundPenile skin zipper entrapment is an emergent medical condition in which the penile skin, scrotal skin, or foreskin gets caught within the teeth of a zipper or the slider itself. This can lead to complications such as urethral involvement, skin loss, or tissue necrosis. We propose a novel technique to aid in the release of entrapped skin utilizing wire cutters directed at the inferior portion of the zipper pull.ObjectivesTo describe a novel technique to free entrapped penile skin and compare its performance to the well-established median bar technique in a simulated setting.MethodsA randomized cross-over design was used to compare techniques on successful release, time to release and tissue injury using an animal model of raw chicken skin entrapped in a zipper. Statistical significance was assessed at p < 0.05.ResultsTwenty-two participants were included. There was no statistically significant difference between the novel technique and the median bar technique regarding successful release (100% vs 95.5%, respectively), median time to release (29.1 vs 26.4 seconds, respectively), or frequency of tissue injury (22.7% vs 27.3%).ConclusionPerformance using our novel technique for removal of penile skin from a zipper is similar to the median bar release technique regarding. Our novel technique may be a valid treatment option for the release of entrapped penile skin in a zipper mechanism in the emergency department setting.Copyright © 2024 Elsevier Inc. All rights reserved.

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