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Zipper Injury to Penis

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1. Zipper Injury to Penis

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 (...) 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

2018 FP Notebook

2. Zipper Injury to Penis

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 (...) 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

2015 FP Notebook

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

-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. A new nonsurgical technique for managing zipper injuries. Full Text available with Trip Pro

A new nonsurgical technique for managing zipper injuries. Zipper injuries are highly distressing to patients and often difficult to manage. Several management techniques are described in the literature. Many are complex and laborious, requiring sophisticated instruments in skilled hands, or even rely on a formal operation. This new technique involves the release of entrapped penile skin from a zipper by cutting the zipper tape and teeth immediately superior and inferior to the zipper connector (...) and using a needle holder to pull the zipper apparatus apart following the application of lubrication and appropriate use of local analgesia. This novel technique is quick, nontraumatic and requires readily available equipment. It has been used successfully in two patients who were ineligible for a circumcision.

2014 European Journal of Emergency Medicine

5. Severe Penile Injuries in Children and Adolescents: Reconstruction Modalities and Outcomes. (Abstract)

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

6. Acute Foreskin Strangulation Injury due to Bathing Suit Mesh Entrapment Full Text available with Trip Pro

Acute Foreskin Strangulation Injury due to Bathing Suit Mesh Entrapment Genital injury can occur at any age of life but is most common in the pediatric population. Hair-tourniquets and circumcision procedures are the most common causes of penile injury in children. Foreskin trauma, aside from zipper related injuries, is sparsely reported. We describe the case of an 8-year-old male who presented with foreskin entrapment caused by bathing suit mesh. Management and literature review are discussed.

2017 Urology case reports

7. 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 (...) examination or procedure. Paraphimosis is a urologic emergency with potential for arterial compression, penile necrosis, gangrene, and/or autoamputation. Hair tourniquet can mimic paraphimosis in the circumcised male. Management: Pain control: topically, parenterally, and/or with a local dorsal penile nerve block or ring block or procedural sedation. Firm compression / methods to reduce edema Firm ACE wrap on the penis to encourage venous outflow Parent’s hand holding constant pressure on the penis

2018 CandiEM

8. 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

9. Family Practice Notebook Updates 2017

( or VTI) Fluid responsiveness is indicated if VTI increases 15% with passive leg raise (urology, procedure) External l sphincter between penile and prostatic is more common than as site of catheter obstruction Male catheterization is eased in a calm patient, with to distend , traction applied to penis, and with a larger, 20 French catheter\ Catheterization of a retracted l meatus (e.g. morbid ) requires assistance to retract redundant tissue, apply suprapubic pressure (surgery, anesthesia, pharm (...) ) 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

2018 FP Notebook

10. Family Practice Notebook Updates 2017

( or VTI) Fluid responsiveness is indicated if VTI increases 15% with passive leg raise (urology, procedure) External l sphincter between penile and prostatic is more common than as site of catheter obstruction Male catheterization is eased in a calm patient, with to distend , traction applied to penis, and with a larger, 20 French catheter\ Catheterization of a retracted l meatus (e.g. morbid ) requires assistance to retract redundant tissue, apply suprapubic pressure (surgery, anesthesia, pharm (...) ) 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

2018 FP Notebook

11. 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

12. 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

13. 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

14. Benign Vulvar Lesions (Follow-up)

. An inflammatory disorder originating from local contact with an agent to which the patient has previously been sensitized, vulvar allergic dermatitis develops 12-48 hours after exposure. Less commonly, vulvar pruritus may coincide with more generalized allergic symptoms. Known allergens include topical medications and various chemicals in products such as perfumes, preservatives, and latex. Nickel sensitivity from snaps or zippers in denim jeans or undergarments may also occur. [ , , ] Topical allergens (...) , Parkinson disease, nerve injury, and syringomyelia have been related to onset or worsening of the disease. Seasonal factors, zinc deficiency, and HIV infection have been linked to this disorder. Psoriasis Psoriasis is a hereditary disorder of the skin that affects approximately 2% of the population in the Western world. The characteristic silver-white scales on erythematous plaques are caused by rapid cell turnover and primarily occur in sites of repetitive trauma, such as the scalp, elbows, forearms

2014 eMedicine.com

15. Nonneoplastic Epithelial Disorders of the Vulva (Diagnosis)

. An inflammatory disorder originating from local contact with an agent to which the patient has previously been sensitized, vulvar allergic dermatitis develops 12-48 hours after exposure. Less commonly, vulvar pruritus may coincide with more generalized allergic symptoms. Known allergens include topical medications and various chemicals in products such as perfumes, preservatives, and latex. Nickel sensitivity from snaps or zippers in denim jeans or undergarments may also occur. [ , , ] Topical allergens (...) , Parkinson disease, nerve injury, and syringomyelia have been related to onset or worsening of the disease. Seasonal factors, zinc deficiency, and HIV infection have been linked to this disorder. Psoriasis Psoriasis is a hereditary disorder of the skin that affects approximately 2% of the population in the Western world. The characteristic silver-white scales on erythematous plaques are caused by rapid cell turnover and primarily occur in sites of repetitive trauma, such as the scalp, elbows, forearms

2014 eMedicine.com

16. Nonneoplastic Epithelial Disorders of the Vulva (Overview)

. An inflammatory disorder originating from local contact with an agent to which the patient has previously been sensitized, vulvar allergic dermatitis develops 12-48 hours after exposure. Less commonly, vulvar pruritus may coincide with more generalized allergic symptoms. Known allergens include topical medications and various chemicals in products such as perfumes, preservatives, and latex. Nickel sensitivity from snaps or zippers in denim jeans or undergarments may also occur. [ , , ] Topical allergens (...) , Parkinson disease, nerve injury, and syringomyelia have been related to onset or worsening of the disease. Seasonal factors, zinc deficiency, and HIV infection have been linked to this disorder. Psoriasis Psoriasis is a hereditary disorder of the skin that affects approximately 2% of the population in the Western world. The characteristic silver-white scales on erythematous plaques are caused by rapid cell turnover and primarily occur in sites of repetitive trauma, such as the scalp, elbows, forearms

2014 eMedicine.com

17. Benign Vulvar Lesions (Treatment)

. An inflammatory disorder originating from local contact with an agent to which the patient has previously been sensitized, vulvar allergic dermatitis develops 12-48 hours after exposure. Less commonly, vulvar pruritus may coincide with more generalized allergic symptoms. Known allergens include topical medications and various chemicals in products such as perfumes, preservatives, and latex. Nickel sensitivity from snaps or zippers in denim jeans or undergarments may also occur. [ , , ] Topical allergens (...) , Parkinson disease, nerve injury, and syringomyelia have been related to onset or worsening of the disease. Seasonal factors, zinc deficiency, and HIV infection have been linked to this disorder. Psoriasis Psoriasis is a hereditary disorder of the skin that affects approximately 2% of the population in the Western world. The characteristic silver-white scales on erythematous plaques are caused by rapid cell turnover and primarily occur in sites of repetitive trauma, such as the scalp, elbows, forearms

2014 eMedicine.com

18. Nonneoplastic Epithelial Disorders of the Vulva (Treatment)

. An inflammatory disorder originating from local contact with an agent to which the patient has previously been sensitized, vulvar allergic dermatitis develops 12-48 hours after exposure. Less commonly, vulvar pruritus may coincide with more generalized allergic symptoms. Known allergens include topical medications and various chemicals in products such as perfumes, preservatives, and latex. Nickel sensitivity from snaps or zippers in denim jeans or undergarments may also occur. [ , , ] Topical allergens (...) , Parkinson disease, nerve injury, and syringomyelia have been related to onset or worsening of the disease. Seasonal factors, zinc deficiency, and HIV infection have been linked to this disorder. Psoriasis Psoriasis is a hereditary disorder of the skin that affects approximately 2% of the population in the Western world. The characteristic silver-white scales on erythematous plaques are caused by rapid cell turnover and primarily occur in sites of repetitive trauma, such as the scalp, elbows, forearms

2014 eMedicine.com

19. Benign Vulvar Lesions (Overview)

contact with an agent to which the patient has previously been sensitized, vulvar allergic dermatitis develops 12-48 hours after exposure. Less commonly, vulvar pruritus may coincide with more generalized allergic symptoms. Known allergens include topical medications and various chemicals in products such as perfumes, preservatives, and latex. Nickel sensitivity from snaps or zippers in denim jeans or undergarments may also occur. [ , , ] Topical allergens in vulvar allergic dermatitis include (...) factor because lesions occur in areas of the skin where sebaceous glands are most active, such as the face, scalp, body folds, and, less commonly, the genitalia. Seborrheic dermatitis is commonly observed in neonates during the early months of life (as a result of sebaceous gland activation by maternal androgens) or after puberty. An association with Pityrosporum yeasts has been noted. Neurologic factors have also been thought to play a role; emotional stress, Parkinson disease, nerve injury

2014 eMedicine.com

20. Nonneoplastic Epithelial Disorders of the Vulva (Follow-up)

. An inflammatory disorder originating from local contact with an agent to which the patient has previously been sensitized, vulvar allergic dermatitis develops 12-48 hours after exposure. Less commonly, vulvar pruritus may coincide with more generalized allergic symptoms. Known allergens include topical medications and various chemicals in products such as perfumes, preservatives, and latex. Nickel sensitivity from snaps or zippers in denim jeans or undergarments may also occur. [ , , ] Topical allergens (...) , Parkinson disease, nerve injury, and syringomyelia have been related to onset or worsening of the disease. Seasonal factors, zinc deficiency, and HIV infection have been linked to this disorder. Psoriasis Psoriasis is a hereditary disorder of the skin that affects approximately 2% of the population in the Western world. The characteristic silver-white scales on erythematous plaques are caused by rapid cell turnover and primarily occur in sites of repetitive trauma, such as the scalp, elbows, forearms

2014 eMedicine.com

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