Port catheter for chemotherapy

SERVICE(S): Breast Clinic

Since chemotherapy treatment requires regular administration of medication directly into the bloodstream, an implantable delivery system (port-a-cath) is recommended. This prevents the need for frequent re-injection of infusions and/or multiple inflammations of the vein (phlebitis).

What is a subcutaneous implantable system?

The subcutaneous port is a fully implantable delivery system used to administer medication into the bloodstream.

The words subcutaneous and implantable refer to the fact that the port is placedcompletely subcutaneous. The port catheter can only be seen from the outside as a swelling under the skin. The port is made of special medically approved materials and designed for safe and long-term use in human bodies.

The port is a plastic or metal slide with a diameter of a few centimetres, with a slightly raised rubber injection site. This makes the rubber easy to find on the surface of the skin, so that injections can be made quickly and easily.

The rubber is made of a high-quality silicone material that seals itself after use. This allows the port to be pierced between 1000 and 2000 times. A special needle should be used for puncturing the system (=gripper). At the bottom of the port is a thin flexible tube, which is inserted into a large blood vessel.

How is the port installed?

The subcutaneous port is placed during a minor surgical procedure. The method of anaesthesia is determined by the surgeon, depending on the general condition of the patient. Your doctor will place the port where it is most suitable for your treatment. The port is almost always placed on the chest, under the collarbone.

The surgical procedure is simple and usually causes little discomfort. You can usually go home the same day.

How does the port work?

A subcutaneous port is used to introduce medication into the bloodstream or to take blood samples.

To gain access to the port, a special needle (= gripper, Huber needle) is pricked through the skin. If the port is pricked shortly after the placement, it may be painful because the wound has not healed completely. In time, this pain will diminish and comfort will prevail (it improves the mobility of the arms and spares your veins).

The needle, attached to a syringe, is pricked through the rubber to the bottom of the reservoir. The medication or fluids enter the reservoir through the needle and directly enter the bloodstream through the catheter.

Caring for your subcutaneous port

The sutures are either applied intracutaneously, and do not need to be removed, or transcutaneously and can be removed after 12 days. Once the wound has healed, no additional special care is required.

After each treatment, the port and the catheter are flushed with a special solution (heparin) to prevent the system from blocking. This treatment creates a so-called heparin lock. This heparin flush is carried out once every 12 weeks.

Daily care is not necessary.

Possible problems with the port

Below is a list of symptoms that may occur. If any of these symptoms occur, or if any other unusual symptoms appear, you should contact your doctor immediately.

  • Discomfort, swelling or pain in the shoulder, neck, neckline or arm
  • Pain or redness at or around the port site, occurrence of fever or other unusual symptoms around the wound (e.g. loss of fluid)
  • A burning sensation when inserting medication.

Answers to frequently asked questions

Will the port affect my daily activities?

Try to avoid strenuous exercise for the first few days after the port catheter is inserted. If necessary, a sling can be used. Once the wound has healed, you can resume your normal activities such as taking a bath or shower, walking or swimming. Try to spare the arm on the side of the inserted port for about three weeks. Ask your doctor or nurse about specific activities and how or when these can be resumed.

Is it necessary to take care of the port?

A bandage is recommended during wound healing. After that, a bandage is not necessary, provided that the port is not used. If you have a running drip, a bandage will be applied to keep the inserted needle in place and protect it.

What do I have to do when I have a question? If I suspect a problem?

Remember that there may be some redness and sensitivity around the wound after the procedure. Normally, this will decrease during the first 48 hours. However, if you notice any unusual changes near the port or wound, such as severe swelling, redness, loss of fluid or pain, please contact the nurse, your attending physician or your GP.

Who pays for the port?

The full cost of placement and care is covered by the health insurance fund.

Can you safely undergo a CT or MRI scan with the port catheter?

These scans can be performed without any problems. For the MRI scan, the port may not be in use. Today's systems are adapted and can be used to administer CT scan contrast.

How long can a port system remain in place?

In principle, the system can be left in place as long as your doctor considers it necessary. The port can be removed after consultation between doctor and patient, depending on the therapy and healing. The system is removed in a minor procedure under local anaesthetic.

Is the system visible?

Your port will look like a small, raised area under your skin. It can be felt and seen, depending on the amount of muscle and subcutaneous fat tissue. A small scar is also visible at the port site. Over time, this scar will become less and less visible.

Last modified on 8 July 2022


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