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Comprehensive updated information about diving and undersea medicine for the non-medical diver, the non-diving medical professional and an excellent reference source for the diving medical specialist.


Uncommon Diving Emergencies


Zipper Caught on Skin or soft parts

Usually a diver has outgrown his wet suit or is getting dressed too quickly to get into the water to see some unusual fish, such as a whale shark or Manta ray and accidentally pulled up penile skin into his zipper. The skin and bathing suit becomes entrapped and crushed between the teeth and the slide of the zipper, thereby painfully attaching the article of clothing to the body part involved (most often the penis or less often the area beneath the chin).

What to do:
Paint the area with a small amount of povidone-iodine or other antiseptic and infiltrate the skin with 1% lidocaine (plain). This will allow the comfortable manipulation of the zipper and the article of clothing. Ice might suffice in the absence of lidocaine.

Cover the area with mineral oil or WD40. This lubricates the moving parts and often frees the skin without having to cut the zipper.

If the mineral oil alone does not work, then cut the zipper away from the article of clothing to leave yourself with a less cumbersome problem.

Cut the slide of the zipper in half with a pair of metal snips or an orthopedic pin cutter. If you are unable to break the two halves of the zipper slide apart using a metal cutter, then take two heavy duty surgical towel clamps or needle nose pliers and place their tongs into the side grooves at both ends of the slide. then grip one clamp firmly in each hand and then twist your wrists in opposite directions. This often will pop the two halves of the zipper slide apart, releasing the entrapped skin.
Pull the exposed zipper teeth apart, cleanse the crushed skin, and apply an ointment such as neosporin.
Tetanus prophylaxis should be administered as needed.

What not to do:
Do not excise an area of skin or perform a circumcision; it only creates unnecessary morbidity for the patient.

References:
Nolan JF, Stillwell TJ, Sands JP: Acute management of the zipper-entrapped penis. J Emerg Med 1990;8:305-307.

Kanegaye JT, Schonfeld N: Penile zipper entrapment: a simple and less threatening approach using mineral oil. Pediatric Emergency Care 1993;9:90-91.


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 Ernest Campbell, MD, FACS All Rights Reserved.



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