Dr. Harlan Stone Makes a Case for Open-and-Shut Zipper Surgery
While laser beams and ultrasound offer exciting innovations in surgical technology, Dr. H. Harlan Stone believes just as strongly in the operating room benefits of a common plastic zipper from the five-and-dime. Stone, head of general surgery at the University of Maryland Hospital at Baltimore, has pioneered a procedure in the United States that literally zips patients open and shut in treating severe cases of pancreatitis.
Removing a large part of an inflamed or abscessed pancreas produces internal bleeding, Stone explains, so packs of gauze are inserted to stem the blood flow. The packs must be changed daily for the first four or five days and every other day for the next five, requiring patients to face repeated operations in which their wounds are reopened and resewn.
Stone, 55, was introduced to the new technique, which involves sewing a zipper to the tough membrane under the skin, during a 1978 medical meeting in Holland. "Normally, I would have laughed, but this Dutch doctor actually carried it off," he says. The advantages are obvious. Conventional surgery to change the gauze pack took an hour or more each time. Now, though patients must still have anesthesia, it's over—zip, zip—in five minutes. Only a dressing is needed to protect the wound and sterilized zipper. When the pack-changing period ends, the zipper is removed and a permanent suture is substituted.
So far Stone has performed the technique successfully on 28 patients. He buys his zippers from neighborhood shops. While the technique may be revolutionary, Stone, a graduate of Yale and Emory, remains wholly conservative in one respect. He can choose zippers of any color but, he admits, "I felt we ought to have proper hospital white. Pastels are not really appropriate."
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