How does the zipper work?

There are two different zipper systems in this range. They solve the same problem in two ways. Which one a garment uses is stated on its product page.

The wrist-to-wrist zipper, one continuous track

Used on the cotton crewneck, the sherpa fleece crewneck, and the pullover hoodie. Patent pending.

One zipper runs the entire way from the cuff of the left sleeve, up the arm, across the chest, down the right arm, to the right cuff. It is a single track. It does not stop at the shoulder.

There are four pulls on that track. Because the pulls move independently, you can open up to two separate windows at the same time, anywhere along the run. Slide two pulls apart at the left inner elbow and you have an opening at the left inner elbow. Slide the other two apart at the chest and you have a second opening at the chest. Bring the pulls back together and the garment closes completely.

What that means in practice:

Access on the left arm, the right arm, or the chest is handled by the same garment. You do not need a left-side version and a right-side version.
If your access point moves, a fistula matures higher up the arm, a graft is placed on the other side, a port is added, the garment still works. You just open a different part of the track.
Two things can be reached at once, for example a needle site and a chest port.

The wrist-to-chest zipper, one per sleeve

Used on the cotton full-zip hoodie, the sherpa fleece hoodie, and the wearable blanket hoodie. The zipper design on the two hoodies is patented.

Each sleeve has its own zipper running from the cuff, up the arm, to the upper chest. Each of those zippers has two pulls and opens from either end. Open the bottom half and you expose the forearm. Open the middle and you expose the inner elbow. Open the top and you expose the upper arm and the front of the shoulder.

The two sleeve zippers are independent. Opening the left one does nothing to the right one. On the two hoodies there is also a normal full-length front zipper, which is separate again.

Why does the zipper run so far up the arm?

Short zip openings at the cuff or the elbow only work if the access point is where the designer assumed it would be. Access points are not standardized. A fistula can be at the wrist, the forearm, or the upper arm. A graft can be a loop in the forearm or a straight graft in the upper arm. A PICC line enters above the inner elbow. A port sits below the collarbone. Cannulation sites are also rotated deliberately, so the same patient is not stuck twice in the same spot.

A zipper that runs the full length of the arm covers all of those positions with one garment, and keeps covering them when the position changes.

What stays covered?

Everything you do not open. That is the point of the design.

Only the section between two separated pulls is open. The rest of the sleeve, the opposite arm, the back, the torso and the shoulders stay closed. You do not take the garment off, you do not push a sleeve up over a fistula, and you are not sitting in a gown or a half-removed shirt for the length of a session.

The zipper opens the outer face of the sleeve. It does not run underneath the arm and it is not positioned to sit against an access site when the garment is closed.

Does the zipper touch my fistula?

The zipper track runs along the sleeve, and the opening is made by separating two pulls at the point you choose, so the hardware sits to the side of the opening rather than across it. Where exactly the tape and pulls sit relative to your own access site depends on your arm and your fistula, and it is worth checking on the first wear before a treatment day rather than in the chair.

If a zipper sitting near an access site is a concern for you, ask your dialysis nurse or your access care team. They know your access.

Can someone else work the zipper?

Yes. The pulls are on the outside of the garment and are reachable by a nurse, technician or care partner without moving the wearer. There is nothing to unfasten behind the back and nothing that has to be done before the person sits down.