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Zipper Injury to Penis

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1. Zipper Injury to Penis

Zipper Injury to Penis Zipper Injury to Penis Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Zipper Injury to Penis Zipper Injury (...) to Penis Aka: Zipper Injury to Penis , Penile Zipper Entrapment From Related Chapters II. Definition Skin of penis becomes entrapped in pants zipper III. Management Consider Pretreatment with (most effective single measure - effective in 95% of cases) Soak the entrapped skin of penis in for 15 minutes prior to attempted procedure Entrapment within teeth of zipper (non-moving part) - effective in 80% of cases Cut horizontally across the zipper at a level above or below the entrapment Gently pull apart

2018 FP Notebook

2. Zipper Injury to Penis

Zipper Injury to Penis Zipper Injury to Penis Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Zipper Injury to Penis Zipper Injury (...) to Penis Aka: Zipper Injury to Penis , Penile Zipper Entrapment From Related Chapters II. Definition Skin of penis becomes entrapped in pants zipper III. Management Consider Pretreatment with (most effective single measure - effective in 95% of cases) Soak the entrapped skin of penis in for 15 minutes prior to attempted procedure Entrapment within teeth of zipper (non-moving part) - effective in 80% of cases Cut horizontally across the zipper at a level above or below the entrapment Gently pull apart

2015 FP Notebook

3. Comparative analysis of five methods of emergency zipper release by experienced versus novice clinicians. (PubMed)

-6757 IM Animals Chickens Clinical Competence Clothing adverse effects Emergency Treatment methods Humans Male Penis injuries Physicians Prospective Studies Simulation Training Skin injuries Time Factors Wounds and Injuries therapy 2016 10 26 2016 11 01 2016 11 12 6 0 2017 9 21 6 0 2016 11 13 6 0 ppublish 27836312 S0735-6757(16)30812-9 10.1016/j.ajem.2016.11.005 (...) Comparative analysis of five methods of emergency zipper release by experienced versus novice clinicians. 27836312 2017 09 20 2017 09 20 1532-8171 35 5 2017 05 The American journal of emergency medicine Am J Emerg Med Comparative analysis of five methods of emergency zipper release by experienced versus novice clinicians. 783-784 S0735-6757(16)30812-9 10.1016/j.ajem.2016.11.005 Oquist Mark M Michigan State University, College of Human Medicine, Department of Emergency Medicine, United States

2017 The American journal of emergency medicine Controlled trial quality: uncertain

4. Severe Penile Injuries in Children and Adolescents: Reconstruction Modalities and Outcomes. (PubMed)

and overall satisfaction.The causes of penile injury in these series were traffic accidents (2), iatrogenic trauma (5), self-amputation (1), electrocution (1), burns (3), dog bite (2), zipper injury (1), and mother's hair strangulation (1). The mean follow-up was 46 months (range, 14-122), and examinations were uneventful, except for 2 fistulae formation after neophallic urethral reconstruction.The main goal of reconstructive surgery is to have a penis with normal appearance and functions. Severe penile (...) Severe Penile Injuries in Children and Adolescents: Reconstruction Modalities and Outcomes. To review our experience with severe penile trauma, mechanism of injury, and their treatment modalities in 16 children younger than 18 years. Management of penile trauma poses diverse challenges to the reconstructive urologist, as injuries vary from abrasions to total emasculation.Analysis of 16 patients with severe penile injuries referred to us between 2002 and 2011 was undertaken. The median age

2013 Urology

5. CRACKCast E174 – Genitourinary and Renal Tract Disorders

is the engorgement of the dorsal corpora cavernosa, resulting in dorsal penile erection lasting more than 4 hours. Three main types: Low flow (ischemic, painful!!!, “limb” threatening!) Sickle cell disease (>50% of pts with SSD have at least one episode) Malignancy (lymphoma; leukemia) Medications Cocaine / drugs of abuse High flow (non-ischemic, not painful, scary!) Trauma, AVM, congenital disease Neurogenic (penis not threatened – harbinger of spinal cord injury) MANAGEMENT: LOW FLOW ***draw an ABG off (...) the dorsal penis: if pH <7.25, PaCO2> 60, Pa02 < 30, and dark coloured blood = LOW flow*** Akin to COMPARTMENT SYNDROME OF THE PENIS hydration, pain control, relief of urinary obstruction, and treatment of underlying conditions. Local anesthesia by a dorsal nerve block or ring block should be performed prior to (1) aspiration, followed by (2) intracavernous injection (ICI) of sympathomimetic drugs (phenylephrine preferred). Remember = 2 and 10 o’clock are safe zones! If no effect with 1 mL of dilute

2018 CandiEM

6. Funtabulously Frivolous Friday Five 224

at the University of Arizona, said horrendously dirty kitchen sponges that are rarely changed are to blame causing e.coli to be spread onto the mugs. [ ] Question 3 What is the most common source of penile injuries in US men? Zippers Nearly 2000 US males sustain a zipper-related penis injury (ZIRPI) annually. A 2013 study in which data were extrapolated from the National Electronic Injury Surveillance System (NEISS) showed that an estimated 17,616 patients presented to emergency departments with ZIRPI

2018 Life in the Fast Lane Blog

7. Patient Modesty: Volume 86

the catheter requires sterile prep of the genital area and underwear are going to be in the way. They won’t fit properly and can apply unwanted pressure to the catheter once placed. This can even cause a pressure injury to the skin. Spic and Span Some people (not you, I’m sure) wear undies that are not very clean. It’s a gross over-generalization to apply that concern to everyone, but for practical reasons, it can be easier to just have everyone take them off. If you’re having a belly surgery, your skin (...) in the operating room. Plus, it can take multiple people to get them off and we genuinely risk workplace injuries (back pain anyone?) to do so. That’s nice, but maybe you still don’t want to ditch your briefs. There may be hospital staff that get their panties in a bunch about your underpants. If you’re an adult, no one can MAKE YOU take off your clothes. If you refuse to do it, you can take your chances that your underwear will be on your body and be clean. But they may need to come off emergently (or because

2018 Bioethics Discussion Blog

8. Family Practice Notebook Updates 2017

) Adequate fundoscopic exam relies on use s are safe to use in emergency department eye evaluation (with caveats regarding contraindications) (ortho, sx, ) Do not forget in children with high mechanism injuries (esp. under age 8 years) Non-displaced s are initially missed in 10%, often have negative XRay (but positive MRI or CT), and may present as should be considered when evaluating the in a child with elbow injury First exclude before diagnosing a red, hot, swollen large joint as gout (tap the joint (...) with greater injury, and risk for placement Over age 65, screen yearly with history (fall in the last year?, How many times?, Injuries?) and if positive, Educate patients on , supplementation, strength and balance s High risk patients warrant medication review, , foot evaluation, evaluation, , formal program Meniscal Tear (ortho, knee) Arthroscopy with debridement offers no longterm benefit in middle aged and older patients (with or without ) Arthroscopy offers no significant improvement in knee catching

2018 FP Notebook

9. Ketamine

Drug of choice for in children Not FDA approved Entrapment of penis in zipper Abscess Imaging studies or or dislocation reduction in adults Excellent in single provider procedures or resource poor environments No and low apnea risk compared with (typically used for adult ) Excellent first-line sedative to allow for controlled evaluation and management (Ketamine 4-5 mg/kg IM) Sedation in Useful in ( ) Ketamine is the only sedative induction agent with properties Analgesia Excellent choice before (...) as below or other Age <3 months of age Theoretical risk of worsening severe coronary ischemia However improves cardiac contractility as well as improving stunned Not contraindicated in , or Older data recommends avoiding in (risk of ) Newer data suggests safe in In fact neuroprotective with increased No adverse effects on in critically ill adults No adverse effect on , neurologic outcomes or increased ACEP 2011 guidelines lists and acute globe injury as contraindications for Ketamine use in children

2018 FP Notebook

10. Family Practice Notebook Updates 2017

) Adequate fundoscopic exam relies on use s are safe to use in emergency department eye evaluation (with caveats regarding contraindications) (ortho, sx, ) Do not forget in children with high mechanism injuries (esp. under age 8 years) Non-displaced s are initially missed in 10%, often have negative XRay (but positive MRI or CT), and may present as should be considered when evaluating the in a child with elbow injury First exclude before diagnosing a red, hot, swollen large joint as gout (tap the joint (...) with greater injury, and risk for placement Over age 65, screen yearly with history (fall in the last year?, How many times?, Injuries?) and if positive, Educate patients on , supplementation, strength and balance s High risk patients warrant medication review, , foot evaluation, evaluation, , formal program Meniscal Tear (ortho, knee) Arthroscopy with debridement offers no longterm benefit in middle aged and older patients (with or without ) Arthroscopy offers no significant improvement in knee catching

2018 FP Notebook

11. Patient Modesty: Volume 86

the catheter requires sterile prep of the genital area and underwear are going to be in the way. They won’t fit properly and can apply unwanted pressure to the catheter once placed. This can even cause a pressure injury to the skin. Spic and Span Some people (not you, I’m sure) wear undies that are not very clean. It’s a gross over-generalization to apply that concern to everyone, but for practical reasons, it can be easier to just have everyone take them off. If you’re having a belly surgery, your skin (...) in the operating room. Plus, it can take multiple people to get them off and we genuinely risk workplace injuries (back pain anyone?) to do so. That’s nice, but maybe you still don’t want to ditch your briefs. There may be hospital staff that get their panties in a bunch about your underpants. If you’re an adult, no one can MAKE YOU take off your clothes. If you refuse to do it, you can take your chances that your underwear will be on your body and be clean. But they may need to come off emergently (or because

2018 Bioethics Discussion Blog

12. Voiding Dysfunction (Follow-up)

surface. The child should remove the underpants or lower them to the ankles to permit relaxed separation of the thighs. During voiding, the child should be comfortable and relaxed and should not be rushed to void (eg, during a television commercial). Boys should be instructed to free their penis before voiding. The zipper or buttons should be completely opened. If the underwear constricts the penis, this should be corrected. Boys should be relaxed and take sufficient time to empty the bladder (...) . . Joinson C, Heron J, von Gontard A. Psychological problems in children with daytime wetting. Pediatrics . 2006 Nov. 118(5):1985-93. . Ollendick TH, King NJ, Frary RB. Fears in children and adolescents: reliability and generalizability across gender, age and nationality. Behav Res Ther . 1989. 27(1):19-26. . Avlan D, Gundogdu G, Taskinlar H, Delibas A, Nayci A. Relationships among vesicoureteric reflux, urinary tract infection and renal injury in children with non-neurogenic lower urinary tract

2014 eMedicine Pediatrics

13. Voiding Dysfunction (Treatment)

surface. The child should remove the underpants or lower them to the ankles to permit relaxed separation of the thighs. During voiding, the child should be comfortable and relaxed and should not be rushed to void (eg, during a television commercial). Boys should be instructed to free their penis before voiding. The zipper or buttons should be completely opened. If the underwear constricts the penis, this should be corrected. Boys should be relaxed and take sufficient time to empty the bladder (...) . . Joinson C, Heron J, von Gontard A. Psychological problems in children with daytime wetting. Pediatrics . 2006 Nov. 118(5):1985-93. . Ollendick TH, King NJ, Frary RB. Fears in children and adolescents: reliability and generalizability across gender, age and nationality. Behav Res Ther . 1989. 27(1):19-26. . Avlan D, Gundogdu G, Taskinlar H, Delibas A, Nayci A. Relationships among vesicoureteric reflux, urinary tract infection and renal injury in children with non-neurogenic lower urinary tract

2014 eMedicine Pediatrics

14. Ketamine

Drug of choice for in children Not FDA approved Entrapment of penis in zipper Abscess Imaging studies or or dislocation reduction in adults Excellent in single provider procedures or resource poor environments No and low apnea risk compared with (typically used for adult ) Excellent first-line sedative to allow for controlled evaluation and management (Ketamine 4-5 mg/kg IM) Sedation in Useful in ( ) Ketamine is the only sedative induction agent with properties Analgesia Excellent choice before (...) as below or other Age <3 months of age Theoretical risk of worsening severe coronary ischemia However improves cardiac contractility as well as improving stunned Not contraindicated in , or Older data recommends avoiding in (risk of ) Newer data suggests safe in In fact neuroprotective with increased No adverse effects on in critically ill adults No adverse effect on , neurologic outcomes or increased ACEP 2011 guidelines lists and acute globe injury as contraindications for Ketamine use in children

2015 FP Notebook

15. Genital Trauma

. Bend involved knee and loop towel or band around the ankle. 3. Gently pull towel or band to stretch muscle on front of thigh pulling ankle toward buttocks... SOCIAL MEDIA Add to Any Platform Loading , MD, Weill Cornell Medical School Click here for Patient Education NOTE: This is the Professional Version. CONSUMERS: Topic Resources Most genital trauma occurs in men and includes injury to the testes, scrotum, and penis. by removing the clitoris, which is done in some cultures, is a form of genital (...) trauma and child abuse. Most testicular injuries result from blunt trauma (eg, assaults, motor vehicle crashes, sports injuries); penetrating testicular injuries are far less common. Testicular injuries are classified as contusions or, if the tunica albuginea is disrupted, as ruptures. Scrotal injury may be caused by penetrating trauma, burns, avulsions, and bites. Penile injuries have diverse mechanisms. Zipper injuries are common. Penile fractures, which are ruptures of the corpus cavernosum, occur

2013 Merck Manual (19th Edition)

16. Zipped Penis

has been archived. It has not been updated since 18/03/2011. External links and references may no longer work. In this article In This Article Zipped Penis In this article Description An area of skin, often of the penis or neck, becomes painfully trapped in a zipper mechanism. Unzipping the zipper will lacerate the skin and cause further damage. Epidemiology This condition is relatively rarely seen, but is the most common cause of prepuce injuries in children. In one study, only 6 boys were seen (...) . ; The management of penile zip entrapment in children. Injury. 1994 Jan25(1):59-60. ; Safe and painless manipulation of penile zipper entrapment. Indian Pediatr. 2006 Mar43(3):252-4. ; Comparing 2 methods of emergent zipper release. Am J Emerg Med. 2005 Jul23(4):480-2. ; Releasing of zipper-entrapped foreskin: a novel nonsurgical technique. Pediatr Emerg Care. 2007 Jul23(7):463-4. ; Treatment of a delayed zipper injury. Urol Int. 200064(1):45-6. Health Tools Feeling unwell? Assess your symptoms online with our

2008 Mentor

17. Blunt, penetrating and ischemic injuries to the penis. (PubMed)

Blunt, penetrating and ischemic injuries to the penis. We describe our experience with treating a series of 40 penile injuries, including 2 gunshot wounds, 1 stab wound, 1 zipper injury and 34 penile fractures, of which 29 were corrected surgically and 5 were managed conservatively, as well as 2 cases of glandular gangrene at 3 large inner city medical centers in a 12-year period. We describe our standard diagnostic and therapeutic modalities, which have evolved with time.Between 1989 and 2000 (...) , 34 patients were evaluated after blunt trauma to the erect penis resulted in penile fracture. Four patients had penetrating trauma to a flaccid penis and 2 had localized penile gangrene. Of the patients with blunt trauma 32 were injured during sexual intercourse and 2 were injured during masturbation. A single gunshot wound occurred during a crime, 2 penetrating traumas were intentionally inflicted and the remaining penetrating injury was due to a zipper. The 2 patients with penile gangrene had

2002 Journal of Urology

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