Zip line – New Noninvasive System for closing Surgical Incisions

Traditionally, the skin surgical incisions for hip and knee replacements were closed using surgical staples made of stainless steel. While staples have been used for a long time with a great deal of success, complications such as skin inflammation, necrosis of the skin edges, and unsightly scarring can occur. Furthermore, staple removal in the office postoperatively can be anxiety-provoking and painful.

A new device called the Zip Surgical Skin Closure device, or Zipline (by Zipline Medical, Campbell, Ca), has been developed that addresses these concerns and improves upon the current methods of skin closure. Unlike staples, the Zipline is a noninvasive device that does not pierce the skin. Instead, there are two rows of hypoallergenic adhesive tapes (one on each side of the surgical incision) between which run multiple evenly spaced plastic “straps”, each of which has a tensioning lock on one side. The tapes are laid down on the skin and then the straps are “zip tied” or tightened as necessary to seal the skin incision. The device is covered with a waterproof bandage and then the tapes are easily peeled off the skin two weeks after surgery.

The Zipline offers several advantages. Because of its mechanical properties, it promotes better blood flow at the incision which can result in improved incisional healing, better cosmesis and less scarring. As it is noninvasive it may reduce the risk of wound complications. It has proven to be gentle on the skin (yet strong) and comfortable for patients. It peels off easily when no longer needed, thus the anxiety and discomfort of suture or staple removal is avoided. From the surgeon’s standpoint it is quick and easy to apply and has been shown to be cost effective.

The Zipline has been used successfuly for quite some time in numerous hip and knee replacement procedures. As it can be used in almost all cases, it had become our closure device of choice with a high degree of patient satisfaction, excellent cosmesis, and low complication rate.