Free a Penis from a Stuck Zipper

Accidents happen, right? But when it involves your private parts it is not only painful but slightly embarrassing as well. Although getting the penis entrapped in a zipper is most common in boys aged 2-12 years old, it can happen in all ages. According to the British Journal of Urology International, more than 17,000 men and boys visited the emergency room with zipper-related injuries between 2002 and 2010. This entrapment occurs when the skin gets caught between the teeth and the slide of the zipper. Although this injury can be very painful, following the steps below can ensure safe removal.

Steps

Treating at Home

1. Calm yourself or your patient. Severe pain and panic is often the first response to the injury regardless of the age of the patient. Before any treatment can be done, it is important to calm the patient (even if that is you).
   • An injured child can be very unnerving so it is important you try to stay calm when you investigate the injury.
   • If your child panics, be reassuring and try to give him or her a focal point, like your face or a favorite toy.
2. Cover the area with mineral oil. Mineral oil contains petroleum and can help lubricate the area and release pressure. Mineral oil and petrolatum are also known to be effective in healing wounds.
   • Pour mineral oil over the penis and zipper. This lubricates the moving parts and often frees the skin without having to cut the zipper.
   • Let it soak in for about 10-15 minutes.
3. Release the skin from the zipper. Before you move to dismantling the zipper, see if you can release the skin by pulling the skin and zipper to opposite directions with your hands.
   • Grasp the area of skin with one hand and the zipper with the other.
   • Slowly and carefully pull the area of skin in the opposite direction as you pull the zipper.
   • Caution: if bleeding or tearing occurs, stop and seek medical attention.
4. Dismantle the zipper. To release the skin, dismantle the zipper from below. This technique can release the pressure between the zipper plates and will free the trapped skin.
   • Option 1: Cut the median bar (the small bridge between the anterior and posterior faceplates) at the front of the moveable zip head in half with wire cutters. This will cause the zipper to fall apart, freeing the skin relatively painlessly.
   • Option 2: Use a small screwdriver and insert the thin blade between the outer and inner faceplates of the zip fastener. Use a twisting motion toward the median bar to widen the gap between faceplates and help disengage the skin.
   • Option 3: If that doesn’t work, use pliers to apply pressure to the zipper and then, cut the teeth of the closed zipper to release the skin.
5. Care for the injured skin. Once the zipper has been released the skin is going to be sensitive and sore. However, it’s important to properly clean and treat the affected area and stop any bleeding.
   • Wash the area with water and mild soap if needed.
   • If there is a bleeding wound present, use a clean washcloth to apply gentle but direct pressure to the wound until the bleeding stops.
   • If the wound is bleeding a lot, you'll need to hold pressure for at least 15 minutes. If that does not stop the bleeding, seek medical attention.
6. Apply a generous layer of petroleum jelly and a sterile pad. To keep the wound protected, apply petroleum jelly over the injured skin and then press a sterile gauze pad over the area. The pad will stick to the petroleum jelly.
7. Watch for signs of infection. Open wounds can lead to infection if not taken care of. Keep a close eye on the area and look for signs of infection, including:
   • Expanding redness around the wound
   • Yellow or greenish-colored pus or cloudy wound drainage
   • Red streaking spreading from the wound
   • Increased swelling, tenderness, or pain around the wound
   • Fever
   • If any of the above signs occur, seek medical consultation.

Treating at the Hospital

1. Go to the emergency room. If you cannot release the skin from the zipper at home or if you feel unqualified to do so, seek medical attention.
2. Ask for a sedative or a painkiller (if needed). If the patient is hysterical, ask the doctor to provide adequate sedation or pain medication to calm the patient enough that the injury can be treated.
   • If the patient is calm enough, sedation may not be needed and local anesthesia may be enough (see below).
3. Allow access the operation site. In order to treat the injury, the doctor may need to cut off the pants, leaving only the zipper around the skin.
   • This will allow a better view of the entrapment and minimizes further injury, such as the weight of the pants pulling on the skin.
4. Ask for a local anesthesia. A local anesthetic (such as lidocaine) or a topical anesthetic (such as EMLA cream) may be applied to numb the skin locally and facilitate its release from the zipper.
   • Dorsal penile block can also be used but is typically saved for difficult entrapments only or those involving a large area of skin.
   • Note: the benefits of a local anesthetic should be weighed against the injection itself and any additional pain resulting from that.
5. Ask to cover the area with mineral oil. This helps reduce friction and can ease the release of the skin. Let the oil soak for about 15 minutes.
6. Allow the doctor to release the skin from the zipper. The skin may be removed in a few different ways depending on where the skin is entrapped.
   • When skin is caught between the teeth, the doctor may cut the zipper above or below the site where the entrapment is and gently pull the teeth apart to release the skin.
   • If the entrapment is within the sliding part of the zipper, the skin is released by cutting the median bar (the small bridge between the anterior and posterior faceplates) to allow the faceplates to fall apart and the entrapped skin to be released.
7. Talk to the doctor if an elliptical skin incision or emergency circumcision is needed (only if necessary). If the skin cannot be freed otherwise, the use of an elliptical skin incision or an emergency circumcision will be performed by an urologist under general anesthesia.

Warnings

• The most important thing to remember is to never unzip the zipper. This will lacerate the skin and cause further damage.

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Sources and Citations

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