Improvising on the Fly: Comparison of a Novel Technique for Emergent Zipper Release to a Well-Established Technique in a Simulated Setting.

emergency foreskin penis procedures urology zipper entrapment

Journal

The Journal of emergency medicine
ISSN: 0736-4679
Titre abrégé: J Emerg Med
Pays: United States
ID NLM: 8412174

Informations de publication

Date de publication:
17 May 2024
Historique:
received: 22 02 2024
revised: 29 03 2024
accepted: 03 05 2024
medline: 28 8 2024
pubmed: 28 8 2024
entrez: 27 8 2024
Statut: aheadofprint

Résumé

Penile 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. To describe a novel technique to free entrapped penile skin and compare its performance to the well-established median bar technique in a simulated setting. A 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. Twenty-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%). Performance 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.

Sections du résumé

BACKGROUND BACKGROUND
Penile 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.
OBJECTIVES OBJECTIVE
To describe a novel technique to free entrapped penile skin and compare its performance to the well-established median bar technique in a simulated setting.
METHODS METHODS
A 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.
RESULTS RESULTS
Twenty-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%).
CONCLUSION CONCLUSIONS
Performance 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.

Identifiants

pubmed: 39191623
pii: S0736-4679(24)00146-X
doi: 10.1016/j.jemermed.2024.05.001
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024 Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

Alex Piszker (A)

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.

Jennifer Goodrich (J)

Department of Emergency Medicine, Trinity Health-Muskegon, Muskegon, Michigan; Department of Osteopathic Medical Specialties, Michigan State University, College of Osteopathic Medicine, East Lansing, Michigan.

Tracy Koehler (T)

Department of Emergency Medicine, Trinity Health-Muskegon, Muskegon, Michigan; Department of Osteopathic Medical Specialties, Michigan State University, College of Osteopathic Medicine, East Lansing, Michigan.

Ryan Offman (R)

Department of Emergency Medicine, Trinity Health-Muskegon, Muskegon, Michigan; Department of Osteopathic Medical Specialties, Michigan State University, College of Osteopathic Medicine, East Lansing, Michigan.

Classifications MeSH