Zipper Entrapment of the Eyelid with a Unique Removal Technique

Zipper entrapment of the skin, although infrequent, has the potential for significant pain and injury. In pediatric patients, entrapment often involves the penile or scrotal skin, however, eyelid entrapment may also occur. Techniques to liberate entrapped skin vary based on mechanism of entrapment relative to anatomy of the zipper.

A 10-year-old girl presented with left upper eyelid zipper entrapment from a sweatshirt. While protecting the globe and surrounding tissue, various methods for removal were unsuccessfully attempted, including unzipping the zipper, breaking the zipper with wire and bolt cutters, and trying to pry apart its faceplates. Ultimately, a vibrating cast saw was used to cut through the median bar, freeing the entrapped skin. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Zipper entrapment of the skin, although infrequent, does have the potential for significant harm, especially if prolonged. Safe and timely liberation of entrapped skin can be enhanced with knowledge of the unique aspects of zipper mechanisms, and the various techniques for freeing entrapped skin.