ABOUT INFUSION PORT PLACEMENT & REMOVAL
What is an infusion port?
If you need frequent intravenous (IV) medicines or blood draws — or both — your healthcare provider may order a port for you. A port is a small medical device that allows providers easy, reliable access to administer medicine to a patient directly into the veins. It makes taking blood samples easier and is generally more comfortable for the patient than multiple needle sticks.
A port is a small medical device that is installed beneath the skin usually in the upper chest. It sits just below the clavicle or collar bone. It is about 1/2″ thick and about the size of a quarter. You can feel its raised center under your skin. A flexible piece of tubing (catheter) is connected to it. This is tunneled under the skin to an area near the neck where it enters a vein. The center of the port is made of a tough, self-sealing, rubber-like material that can be punctured through the chest skin with a special needle many times. After each puncture, it will reseal instantly. You may hear a port referred to as a portacath; one of the trade brand names such as Passport, Infuse-a-Port, Medi-Port, or Lifesite; central venous access device; or totally implantable venous access system.
Is a port noticeable?
The port, which is implanted under the skin, is not very noticeable. Once healed, it requires little care from you. You can go about with your normal daily routine, which can include swimming and showering, without worrying about the port.
Who can perform this procedure? Where can it be done?
Infusion port placements and port removals can be performed by an interventional radiologist, a physician trained in image-guided, minimally invasive procedures, or a surgeon. It can be performed in the outpatient setting as well as the hospital setting.
Both infusion port insertion and removal can be performed in our offices at 8200 East Belleview Ave, Englewood, Colorado 80111 or in the hospital setting. The cost of placement and removal is lower in the outpatient setting.
How do I prepare for the port insertion procedure?
Make sure you arrange for a responsible driver to take you home, since you may receive conscious sedation. Please let us know in advance if you take blood thinners, are allergic to anything, or are pregnant. Ask about your normal morning medicines, which you may be able to take with a sip of water. Do not eat anything for 6 hours prior to the procedure. You may enjoy clear liquids such as clear juices or black coffee up until 4 hours before the port insertion. Wear comfortable clothing and a top that is easy to take off. For women, wear the type of bra that you normally wear. We will mark where the strap lays on your skin so that the port is inserted in an area where the bra strap will not rub the port.
Again, you MUST have someone with you to drive you home after the procedure. Since you are receiving sedation for the port insertion, you should not drive nor make important personal or business decisions until the following day.
How is an infusion port inserted? How is it removed?
A port is most commonly inserted as a day surgery procedure in a hospital or in a clinic by a surgeon or an interventional radiologist. Many patients prefer the outpatient setting because the cost is generally less than in a hospital setting. The port placement (or removal), generally considered a minor procedure , is typically performed using local anesthesia and conscious sedation. The port is placed beneath the skin in the upper chest, just below the collar bone and is connected to a vein using a catheter (tube). Prior to the procedure, you will have had labs. An intravenous line (IV) will be placed in your arm, which will be used later to deliver an antibiotic, a sedative to help you relax, and pain medicine. Next, the chest area and neck will be cleansed with a special soap. To reduce the risk of infection, your chest, neck and head will be covered with a sterile drape in a manner that is both comfortable and so that you can both see and breathe easily. Once ready for the port placement, the IV will be used and the interventional radiologist will inject a local anesthetic under your skin in the chest area. You will only feel it for a few seconds and then the skin will be numb. Under the guidance of fluoroscopy (real-time x-ray images viewed on a nearby monitor), the interventional radiologist will insert a small tube (called a catheter) into the vein in your neck. A small pocket, into which the port will be placed, will be formed under your chest skin approximately 2-3 inches below your collarbone. After that, the tubing that is connected to the port is tunneled under the chest skin so that it enters the neck vein.
Once everything is in place, the port pocket is sealed either with a sterile surgical glue and sometimes surgical stitches. The neck site is also be closed with special tape. When no longer needed, the port can be removed in the hospital or in the outpatient setting in a similar fashion.
What are the risks?
The two risks are:
- Infection – While there is little risk of infection once the port is in place and healed, there is some risk of infection until the port heals. The other time the port is at risk of infection is when the port is being “accessed” or used. Only a healthcare person trained to access the port should do so.
- Bleeding – To insert the device, a small incision is made in the check skin. Therefore, there is a chance of bleeding or f bruising from the incision. However, prior lab work is done before the port is placed by your referring doctor to make sure your blood clots properly. Therefore, there is generally not concern about excessive bleeding.
How do I care for the port?
Immediately after the procedure:
- Keep the port site dry until you have your post-procedure check, which is generally scheduled 7 – 10 days after the placement. You can use clear plastic food wrap and tape to cover the site to shower. The goal is to prevent infection until the incision is completely healed.
- Keep a dressing over the site for the first 3 days. After that, nothing is needed except to keep the area dry and exposed to air under your shirt.
- Patients sometimes have a little discomfort after the procedure. This can be managed with medicine usually for up to 48 hours. Sometimes, over-the-counter medicines that you generally take for aches and pains can be used if there is discomfort at the port site.
- Women should wear a bra during the day.
Call us if you notice that the port site has signs of infection such as:
- Extreme pain and/or tenderness
- Pus drainage
- Extreme warmth by the placement site
- Excessive bleeding and/or swelling
- Fever about 101 degrees in 2 readings taken four hours apart
Once the port has healed:
If the port is not being used regularly, it will need to be flushed once a month so that it does not clot off. This flushing procedure is done at the clinic that used your port for treatments and/or blood draws.