1.What is it?
- Zipstitch is an FDA approved technology proven to be more effective than stitches or staples for wound closures, both in and outside of surgery. It is also available commercially to help in closure of small to medium size lacerations outside of hospital. (1)
2.Why is it important?
- When small or medium lacerations occur, it may be difficult to deal with the wound using traditional household supplies; as plasters only cover very small cuts and bandages may not effectively close the wound to promote the fastest possible healing.
- Therefore, in situations such as cuts from kitchen knives or minor accidents, that do not require formal medical attention, they may be more effectively treated with Zipstitch compared to traditional methods.
- Furthermore, several studies have indicated that this technology would be more effective than comparative techniques for the following reasons:
- Zipstitch is faster to implement than stitches (2)(3)
- 8 times stronger wound protection than sutures to promote healing (4)
- Less scarring than stitches (5)
- Less pain than stitches (6) with fewer wound complications (7)
- No punctures that allow bacteria into the site
- Bio-compatibility tested, being made with hypoallergenic material
- Due to the above results, in particular the reduced scarring and stronger wound closure, this Zipstitch technology has been used effectively to close even major procedures. This has been seen in several different operations such as closure of total knee replacement and shoulder replacements with minimal scarring as seen in provided images. (1)
3.How does it work?
- Zipstitch uses cable tie clasps to more precisely close the wound and align the edges of the skin.
- There are several steps to this process:
- Hands must be cleaned before application
- Control bleeding of wound by applying pressure
- Clean the wound to prevent infection, with large fragments and debris removed and the wound irrigated thoroughly in water
- Dry the wound and surrounding skin with clean gauze (adhesive works better on clean, dry skin)
- Remove liner and place Zipstitch over wound and press adhesive firmly on both sides, then remove white paper cover
- Gently pinch the wound closed by pulling on the straps, stopping just when skin touches
- If clean scissors are available – cut off the ends of the ties
- Apply dressing over the device, ensuring that no adhesive touches it, as it may result in the Zipstitch being ripped off when dressing is removed
- Lalani, G. G., Schricker, A. A., Salcedo, J., Hebsur, S., HSU, J., Feld, G. and Birgerdotter-Green, U. (2016), Cardiac Device Implant Skin Closure with a Novel Adjustable, Coaptive Tape-Based Device. Pacing and Clinical Electrophysiology. . doi:10.1111/pace.12926
- Goldman DS, Hammill E, Aasbo J, Storne E, Reddy S. Improvement in S-ICD Incision Closure Time and High Implanter Satisfaction Using a Novel Skin Closure Device Scientific presentation given at Asia-Pacific Heart Rhythm Society 2017 Meeting; Sep 16, 2017; Yokohama, Japan.
- In an in-vivo study, more load in lb. was required to create a 1mm gap between incision edges approximated with Zip than with Ethicon 4-0 Vicryl® subcuticular running suture. Data on file.
- Tanaka, Y. et al. Randomized Study of a New Noninvasive Skin Closure Device for Use After Congenital Heart Operations. Ann Thorac Surg 2016.
- Carli AV, Spiro S, Barlow BT, Haas SB. Using a non-invasive secure skin closure following total knee arthroplasty leads to fewer wound complications and no patient home care visits compared to surgical staples. Knee. 2017 Oct;24(5):1221-1226.
- Emerson, Dr. Roger, Non-invasive, zip type skin closure device vs. conventional staples in total knee arthroplasty: Which method holds greater potential for bundled payments? Presentation, The Knee Society, 2017.
All images belong to Zipline Medical Inc. except featured image by Med X – Jannat Alam
Author – Shahmeer Noori, Medical Student