{"title":"甜蜜释放:在模拟环境中比较拉链紧急松开的新技术和成熟技术","authors":"","doi":"10.1016/j.jemermed.2024.05.001","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>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.</p></div><div><h3>Objectives</h3><p>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.</p></div><div><h3>Methods</h3><p>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 <em>p</em> < 0.05.</p></div><div><h3>Results</h3><p>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%).</p></div><div><h3>Conclusion</h3><p>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.</p></div>","PeriodicalId":16085,"journal":{"name":"Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":1.2000,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Improvising on the Fly: Comparison of a Novel Technique for Emergent Zipper Release to a Well-Established Technique in a Simulated Setting\",\"authors\":\"\",\"doi\":\"10.1016/j.jemermed.2024.05.001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>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.</p></div><div><h3>Objectives</h3><p>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.</p></div><div><h3>Methods</h3><p>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 <em>p</em> < 0.05.</p></div><div><h3>Results</h3><p>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%).</p></div><div><h3>Conclusion</h3><p>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.</p></div>\",\"PeriodicalId\":16085,\"journal\":{\"name\":\"Journal of Emergency Medicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.2000,\"publicationDate\":\"2024-05-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Emergency Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S073646792400146X\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"EMERGENCY MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Emergency Medicine","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S073646792400146X","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"EMERGENCY MEDICINE","Score":null,"Total":0}
引用次数: 0
摘要
背景阴茎皮肤拉链卡住是一种紧急医疗状况,即阴茎皮肤、阴囊皮肤或包皮被拉链齿或拉头本身卡住。这会导致尿道受累、皮肤脱落或组织坏死等并发症。我们提出了一种新技术,利用针对拉链拉头下部的钢丝钳来帮助释放被夹住的皮肤。方法采用随机交叉设计,使用拉链夹住生鸡皮的动物模型,比较释放成功率、释放时间和组织损伤方面的技术。统计显著性以 p < 0.05 为标准。在释放成功率(分别为 100% vs 95.5%)、释放中位时间(分别为 29.1 vs 26.4 秒)或组织损伤频率(分别为 22.7% vs 27.3%)方面,新技术与中位横杆技术没有统计学意义上的显著差异。我们的新技术可能是在急诊科环境下释放拉链装置中夹住的阴茎皮肤的有效治疗方案。
Improvising on the Fly: Comparison of a Novel Technique for Emergent Zipper Release to a Well-Established Technique in a Simulated Setting
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
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
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
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
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.
期刊介绍:
The Journal of Emergency Medicine is an international, peer-reviewed publication featuring original contributions of interest to both the academic and practicing emergency physician. JEM, published monthly, contains research papers and clinical studies as well as articles focusing on the training of emergency physicians and on the practice of emergency medicine. The Journal features the following sections:
• Original Contributions
• Clinical Communications: Pediatric, Adult, OB/GYN
• Selected Topics: Toxicology, Prehospital Care, The Difficult Airway, Aeromedical Emergencies, Disaster Medicine, Cardiology Commentary, Emergency Radiology, Critical Care, Sports Medicine, Wound Care
• Techniques and Procedures
• Technical Tips
• Clinical Laboratory in Emergency Medicine
• Pharmacology in Emergency Medicine
• Case Presentations of the Harvard Emergency Medicine Residency
• Visual Diagnosis in Emergency Medicine
• Medical Classics
• Emergency Forum
• Editorial(s)
• Letters to the Editor
• Education
• Administration of Emergency Medicine
• International Emergency Medicine
• Computers in Emergency Medicine
• Violence: Recognition, Management, and Prevention
• Ethics
• Humanities and Medicine
• American Academy of Emergency Medicine
• AAEM Medical Student Forum
• Book and Other Media Reviews
• Calendar of Events
• Abstracts
• Trauma Reports
• Ultrasound in Emergency Medicine