Lidocaine gel eases the pain of removing an entrapped zipper | Image credit: Contemporary Pediatrics

The case:

A case report describes how physicians in the emergency department of a Korean hospital removed a zipper entrapped on an 8-year-old girl’s eyelid by using a lubricating gel to provide local anesthesia. The child arrived in the emergency department after she tried to close the zipper on a jacket she was pulling over her head, leaving approximately 1 cm of the right upper eyelid entrapped in the lower back portion of the zipper teeth.

To provide analgesia lubrication before releasing the zipper, physicians applied a sterile gel containing lidocaine and chlorhexidine to the skin surrounding the engaged eyelid. They also used sterile gauze and paper tape to cover the child’s right eyebrow and globe to prevent the gel from irritating the cornea or conjunctiva, exposing the entrapped eyelid only before application. After allowing 5 minutes for the lidocaine to take effect, an emergency physician slowly released the slider piece of the zipper from the eyelid skin. A pediatric nurse and the girl’s father provided distractions during the procedure.

THOUGHTS FROM DR FARBER

Less pain and no need for sedation are major benefits. The eyelid is not the first place I think of when I hear about entrapped zippers, particularly in boys, but I imagine this will work in other locations as well. Keep this trick in mind!

Reference:

Choi SY, Hwang S. A case of successful removal of a zipper entrapped on the upper eyelid of a child using a lidocaine gel. Pediatric Emergency Medicine Journal. 2024;11(2):71-74. doi:10.22470/pemj.2024.00962