Implanted Port

What is an implanted port?

An implanted port is a small medical device placed under the skin in your chest, arm or belly (abdomen). It allows healthcare providers easy access to a vein for giving medications, IV fluids and blood transfusions and for taking blood draws. It’s particularly useful if you need these procedures repeatedly over a long period of time. Providers may also call your implanted port a portacath or mediport.

The implanted port itself is a small, flat metal or plastic disc with a silicone access point (septum) on top. The septum is a self-sealing rubber injection site that a needle can pierce to access the port. A thin, flexible tube (catheter) is attached to the port and threaded into a large vein near your heart. Your provider places the entire system under your skin during a minor surgery. When you no longer need it, your provider takes it out.

If you need frequent IV treatments or other medical procedures, an implanted port can help reduce the number of needle pokes you have to receive. This can make your treatments more comfortable and less stressful.

What are the types of implanted ports?

Types of implanted ports include:

• Single lumen: This port has one access point (septum). It’s the most common type.
• Double lumen: This triangular-shaped port has two access points to a vein. Two ports are helpful if you need to get more than one medication at the same time.
• Power-injectable: Many single- and double-lumen ports are power-injectable. Providers can inject contrast dyes into the port to perform imaging scans like CT scans (computed tomography scans) and MRIs (magnetic resonance imaging).

Who may need an implanted port?

Implanted ports work for anyone who needs frequent or long-term IV treatments, blood transfusions or blood draws.

A healthcare provider may recommend a port if you or your child has:

• A complex medical condition that requires IV fluids or frequent blood draws.
• Cancer that requires chemotherapy.
• An infection that requires long-term IV antibiotics.
• Inflammatory bowel disease (IBD) that requires parenteral (IV) nutrition or biotherapy.
• Kidney failure that requires dialysis.

What happens before a port implant procedure?

Before you get an implanted port:

• Review the medications and supplements you take. They may ask you to stop taking certain ones.
• You may get blood tests to check your kidney function and how your blood clots.
• You may be asked to fast (not eat or drink) for a certain amount of time before the procedure.

How is an implanted port inserted?

A port implant is an outpatient procedure that takes about an hour. That means you can go home the same day, but you should arrange to have someone drive you.

Most people get ports under the skin on the right side of their chests. Sometimes, providers place ports in the inner side of your upper arm or in abdominal skin below your ribcage.

An anesthesiologist will give you anesthesia to put you into a light sleep. They’ll also provide local anesthesia to numb the surgical site. If you’re an adult, you may be conscious during the procedure but won’t remember it. Your child may have general anesthesia to sleep more deeply through the procedure.

To place a port, your provider:

1. Uses continuous X-ray imaging (fluoroscopy) to guide the procedure.
2. Makes a small cut (incision) in your neck area to reach your vein (typically, your superior vena cava, jugular or subclavian vein).
3. Creates an access point in your vein.
4. Makes a small incision in your chest, arm or abdomen to place the port.
5. Uses that incision to create a pouch under the bottom (subcutaneous) layer of skin.
6. Places the port in the pouch of skin.
7. Threads the catheter from the port to your vein.
8. Uses the neck incision to connect the catheter to your vein.
9. Performs a chest X-ray to make sure the device is in the right spot.
10. Closes the incisions with dissolvable stitches.

What happens after a port implant procedure?

You may be able to feel or see a slight bulge in your skin from the port. You won’t see the port or its rubber cap once the incision heals. Your provider will prescribe medications to help with discomfort as it heals.

You’ll need to wear a bandage over the incision site. Once the incision heals, you shouldn’t have any discomfort. Avoid lifting anything heavy or doing strenuous activity until your provider gives the OK.

How do implanted ports work?

You may go to your provider’s office to receive treatments. For your child, your provider may teach you how to give some treatments at home using the port. Blood draws and transfusions take place at a healthcare facility.

To give IV treatments, you or a healthcare provider:

1. Prepares the space. If you’re at home, be sure the table is clean and disinfected.
2. Washes hands well, and makes sure everyone in the room wears a face mask that covers their mouths and noses.
3. Applies an anesthetic cream to numb the skin over the port (if needed). Over time, the skin over the port thickens, making it less sensitive to needle sticks.
4. Sterilizes (clean) your skin with an antiseptic.
5. Places a sterile dressing (bandage) on the skin covering the port to lower infection risk.
6. Inserts a thin needle into the septum (silicone top).
7. Gives the medicine or draw blood.
8. Uses another needle to flush the device with a solution that helps prevent blood clots.
9. Gently removes the needle and covers the site with a bandage.
10. If the needle needs to stay in place, the bandage will be clear. This is so you can watch for signs of infection, like red streaks, or leaking from the site.

How long can an implantable port stay in?

Ports can last for years. They can handle up to 2,000 needle sticks before replacement becomes necessary.

How are implanted ports removed?

Port removal is faster than placement. Adults may not need anesthesia but anesthesiologists put children to sleep. Your healthcare provider will give you a plan to manage any discomfort after port removal.

Your provider:

1. Applies numbing cream to your skin.
2. Makes a small incision in the skin at the port site.
3. Gently pulls on the catheter to dislodge it from your vein.
4. Removes the port and catheter through the incision.
5. Uses dissolvable stitches to close the incision.

What is the benefit of placing an implanted port?

An implanted port offers many benefits. With the device, you can have:

• At-home treatments like chemotherapy or dialysis.
• Fewer needle sticks. You may even have multiple blood tests and treatments in the same day with just one needle stick.
• More than one medicine at a time (if you have a double-lumen port).
• Treatments (like strong antibiotics) that last multiple days.

The port reduces your risk of:

• Leaks of IV fluid from a vein and into nearby tissues.
• Vein damage (like from strong chemotherapy) or ruptures.

What are the potential risks or complications of an implanted port?

About 1 in 3 people have problems with implanted ports. Infections are the most common complication. Any infection raises the risk of a potentially life-threatening infection called sepsis.

Other potential complications include:

• Blockages in the port or catheter.
• Blood clots in the catheter or vein.
• Collapsed lung (pneumothorax).
• Cracked port.
• Dislodged catheter tip.
• An air bubble in a blood vessel (embolism).
• Blood that pools in the space between your chest wall and lungs (hemothorax).

How do I care for an implanted port?

The skin covering the port doesn’t need any special care. If you aren’t receiving regular treatments, you or your provider may flush out the port and catheter once a month. Flushing lowers the risk of clots and blockages. It keeps the line open and ready for the next use.

What can I do to help prevent infection?

Infections sometimes happen even if you do everything right. But to help protect yourself, it’s important to maintain good hygiene by:

• Bathing daily.
• Brushing your teeth at least twice each day.
• Keeping your environment and bed clean.
• Washing your hands for at least 20 seconds using soap and running water. Wash them many times throughout the day, and before doing anything with your implanted port.

Do I need to restrict activities while I have an implanted port?

After the incision site heals, you can resume most activities. You should check with your healthcare provider about participating in contact sports like football or high-impact activities.

When should I call my healthcare provider?

You should call your healthcare provider if you experience:

• Bleeding or fluid around the port site.
• Dizziness or fainting.
• Shortness of breath.
• Signs of infection, like fever or redness, swelling and warmth at the port site.
• Swelling in your arm on the same side as the port.