When Compared to Staples, Zip Cuts Post-Discharge Clinic Costs for
Problem Patients, Wound Checks and Removal by 50 Percent

CAMPBELL, Calif. and COLUMBUS, Ohio – September 18, 2017 — ZipLine
Medical, Inc. today announced results from an economic study that showed that
Zip Surgical Skin Closure reduced post-discharge costs for total knee
arthroplasty (TKA) when compared to staples. Results were presented Friday at
the Knee Society Members Meeting by Roger Emerson, MD, of the Texas Center
for Joint Replacement, Plano, Texas.

“In the study, we saw that staples and the Zip are both fast to apply in the
operating room, but in the post-discharge environment, staple-related issues,
such as patient phone calls, emergency department visits, infection concerns
and removal create extra work and extra cost in the long run,” said Dr. Emerson.
“In addition, patients were apprehensive about staple removal and concerned
when they saw redness around their staples, which in some cases triggered
antibiotic prescriptions to avoid possible infection.”

The study encompassed 130 consecutive TKA patients, with half of subjects
closed with staples and half closed with Zip Surgical Skin Closure. All surgeries
were performed at the Texas Center for Joint Replacement by the same surgeon
using the same approach and implant, and were closed by the same surgical
physician’s assistant. Patients were followed from surgery to first clinic postoperative
visit (day 21-28) for assessment.

The study findings showed that the Zip reduced all of the following measures
when compared to staples:
• 46 percent reduction in incision-related actual clinic costs
• 60 percent reduction in incision-related phone calls
• 60 percent reduction in incision-related clinic visits
• 75 percent reduction in incision-related antibiotics prescribed

In addition, patients found the resulting scar from the Zip to be cosmetically
more appealing, and the Zip device less painful to remove, than staples.

”In addition to actual emergency room, clinic and wound-related care costs,
which can be considered ‘bundle-busters’ in a bundled care setting, there are
opportunity costs to consider, where unreimbursed time responding to patient
calls, concerns and staple removal results in less time spent on billable
activities,” said Omar Alnachoukati, director of clinical research at the Texas
Center for Joint Replacement. “In the study, we found a five times higher
opportunity cost in the staple group.”

He continued, “Total joint arthroplasty is the largest expense for a single
condition among Medicare beneficiaries, totaling $7 billion annually. With
staples currently one of the primary methods currently used for TKA closure,
this study suggests that replacing staples with the non-invasive Zip device has
the potential to offer significant savings to the healthcare system.”

The Zip is a non-invasive and easy to use skin closure device that replaces
sutures, staples, and glue for surgical incisions and lacerations. Clinical studies
have demonstrated significant time savings, fewer wound complications and
the ability to reduce post discharge healthcare costs. A patented force
distribution design results in secure wound closure, excellent scar quality and
high patient satisfaction. Unlike staples or sutures, there are no skin punctures
with the Zip that can create pathways for bacteria. Benefits of the Zip have
been demonstrated in clinical studies in orthopedic total joint arthroplasty, foot
and ankle, pediatric cardiothoracic, electrophysiology, dermatology, and
plastic and reconstructive surgery.

ZipLine Medical is an innovator in cost-effective, non-invasive surgical skin
closure devices that deliver high patient satisfaction and surgeon efficiency.
Zip Surgical Skin Closure devices have been used in more than 100,000 cases
and in over 30 countries worldwide. ZipLine Medical was founded by Amir
Belson, M.D. and is headquartered in Campbell, CA. For more information,

Zip® Surgical Skin Closure devices are classified by the U.S. FDA as ‘Class I,
510(k) Exempt’ and have received the CE Mark and CFDA approval.


Michelle McAdam, Chronic Communications, Inc., 310.902.1274

MA10593 Rev B

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