Z-track technique for paracentesis

Last revised by Matt A. Morgan on 27 Jun 2021

The Z-track technique is used for paracentesis. It produces a non-linear track between the dermis and the peritoneum, and this serves to decrease the chance of ascitic fluid leakage through the track.


Instead of directly sticking the access needle from the skin surface into the peritoneal cavity, the non-needle hand gently slides the skin and subcutaneous tissues to one side before access. When the needle is removed and the stretched skin slips back into its original place, the result is that what was a direct access track now tracks diagonally through the skin (a "Z" shape) and the pressure of the subcutaneous tissues on this diagonal track helps seal it shut.

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