An American surgeon creates controversy after using zippers in place of stitches - July 11th, 1985

On this day in 1985, Dr. Harry Harlan Stone announced the successful use of zippers to open and close surgical incisions.

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Episode Transcript

Speaker 1 (00:00):
The Day in History Class is a production of I
Heart Radio, Hello and welcome to this Day in History Class,
a show that proves there's more than one way to
make history. I'm Gay Bluesier, and today we're looking at

(00:21):
a radical solution to a longstanding surgical problem, as well
as the unexpected controversy had caused among the makers of zippers.
The day was July eleven. Doctor Harry Harland Stone announced

(00:46):
the successful use of zippers to open and close surgical incisions.
Although the technique was already in limited use by surgeons
in England, Germany, and Belgium, Stone was the first in
the United States to install a zipper on a patient.
He explained that the seven inch polyester zippers were especially

(01:07):
useful in cases where it was likely he would need
to re operate on a patient. Instead of reopening and
then re stitching the same wound again and again, he
could simply zip and unzipped the patient as needed. Then,
after a period of five days to two weeks, the
adhesive patch with the zipper in the middle could simply

(01:27):
be removed and discarded. Doctor Stone developed his breakthrough technique
while working as the chief of General Surgery at the
University of Maryland Hospital in Baltimore. He had been looking
for a way to improve the survival rate of critically
ill patients who had undergone surgery for pancreatitis or pancreatic swelling.

(01:48):
Operating on the pancreas has always been a challenge for surgeons,
and one of the most dreaded complications that can arise
from such procedures is postoperative bleeding. This occurs it's necessary
to periodically remove and replace the internal bandages and gauze
that were applied during surgery. To do this, surgeons normally

(02:10):
have to remove the stitches from an abdominal incision, change
the internal bandages, and then re stitched the wound. This procedure,
which requires the use of anesthesia, can take up to
an hour each time. For patients and critical condition that
repeated strain can be too much to bear. For example,

(02:31):
even though bleeding after pancreatic surgery occurs and only about
five to sixteen percent of cases, the morbidity for those
who experience it was as high as ninety percent in
the mid nineteen eighties. However, according to doctor Stone, swapping
stitches for zippers made all the difference. Suddenly, he could

(02:52):
change an internal bandage in just five minutes while standing
at a patient's bedside and without the need for anesthesia.
On July eleventh, Stone revealed that he had already used
the zippers on twenty eight pancreatic surgery patients and that
their recovery rate had risen to ninety percent. He told

(03:12):
the press, quote, all of us have talked about zippers,
but it was passed off as a joke. Now that
comical pipe dream has become a beneficial reality. Stone's technique
may have been unorthodox, but he did play it safe
in at least one respect. Even though he could have
used any color zipper he wanted, Stone said quote, I

(03:35):
felt we ought to have proper hospital White pastels are
not really appropriate. The zippers themselves weren't anything special. They
were regular polyester zippers made by the y k K Group,
the world's largest zipper manufacturer. The white seven inch model
favored by doctor Stone was the same kind commonly used

(03:57):
in women's skirts. At first, the multinational zipper company was
pleased with the surgeon's clever new use for their product,
but when some medical professionals began to balk at the
largely untested technique. The people at y k k's US
division started to get a little nervous. They worried what

(04:17):
might happen if they're zippers led to some kind of
medical complication. Not only would it lead to bad publicity,
the company might even be held legally responsible. To get
ahead of that potential problem, the company's vice president of
Global Marketing sent a letter to one of the world's
leading medical journals, the New England Journal of Medicine, printed

(04:39):
in the November issue, under the headline if you Snip,
Don't Zip, The letter read as follows, to the editor,
we are a manufacturer of zippers. It has recently come
to our attention that at least one physician is using
our zippers to close surgical incisions. Our products are not

(05:00):
designed or manufactured for medical purposes and were never intended
for such use. In addition, our product is not sterile
or packaged or manufactured in a medically sterile environment. During
the manufacturing process, our zippers are in contact with or
made with oils, lubricants, detergents, dye stuff, and other common chemicals. Therefore,

(05:23):
illness or injury may result if this product is used
for surgical purposes. We urged journal readers not to use
zippers for medical purposes. We cannot be responsible for any
injury caused by such use. While y k K is concerned,
seems valid and understandable, Doctor Stone didn't appreciate the implication

(05:45):
that he may have installed tainted zippers and his patients
all the zippers he used had, of course, been sterilized.
Stone clapped back at the company with a letter of
his own, which was also published in the New England
Journal of Medicine. Brief to the point loaded with sass.
Stone's letter said, quote to the editor, the use of

(06:05):
the zipper has greatly facilitated re exploration of the abdomen
when it is required on an almost daily basis. We
have tried many different zippers over the past few years.
Our initial studies used the y k K, but at
present we prefer the talent since it is less likely
to disengage spontaneously and lead to evisceration. H. Harlan Stone,

(06:31):
m d. This bizarre feud only brought more attention to
the story as more and more reporters began reaching out
to y k K for comments on the medical use
of zippers. This led to one exasperated official, telling the
United Press International quote, We're just trying to make zippers
to keep pants up and skirts on. In the years

(06:53):
that followed, doctor Stone was hit with two medical malpractice lawsuits,
but much to the relief of zipper manufacturers, neither case
involved patients who had been fitted with zippers. Instead, the
cases revolved around doctor Stone and other surgeons at University
Hospital claiming that a patient had died of natural causes,

(07:14):
when in reality surgical mistakes were to blame. Those two cases,
along with two other malpractice complaints filed in the same
nine week period, led the hospital to call for Stone's resignation.
He begrudgingly complied, and in the wrongful death cases were
settled out of court for an undisclosed but very substantial

(07:35):
sum of money. Dr H. Harlan Stone later took on
surgical training positions at the University of Arizona and the
University of South Carolina. Though his career as a professional
surgeon was effectively over, he continued to write medical books
and give lectures until his death on April seventh, two

(07:56):
at the age of ninety two. As for y K
a K, they actually branched into medical products in the
late ninety nineties, and today they manufacture a variety of
products and machinery for use in hospitals, including everything from
blood pressure cuffs and tourniquets to hospital curtains and ppe.
The company's zippers still aren't intended for surgical use, but

(08:20):
other manufacturers have introduced their own surgical zippers specifically designed
to secure surgical incisions for repeated access. Not only are
these zippers less invasive than traditional staples and sutures, they
also lead to fewer infections and less irritation and scarring.
Unlike the over the counter zippers used by Stone, modern

(08:43):
surgical zippers are made from medical grade polyethyly, so don't
expect to find them on a women's skirt anytime soon.
I'm Gave Luzier and hopefully you now know a little
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(09:05):
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