How to take care of the venous access?

After the wound heals after port implantation (about 7-8 days), you can lead a normal life, but intense efforts and some sports will need to be restricted for a month, especially intense physical activity involving the pectoral muscle where the port is located after implantation will be contraindicated, i.e. step per, tennis, golf, swimming, javelin throw.

The skin over the port does not require the use of ointments or creams.

As of fall 2018, the recommendation to flush an unused port once a month is no longer valid. This frequency of additional port punctures has been found to increase the risk of port pocket infection without providing significant benefit to the patient.

The port must be flushed out after each use - whether after drawing blood for laboratory tests, transfusing a chemotherapeutic agent, or injecting pressurized contrast for radiological studies - enough saline solution should be injected into the port so that nothing else is in the port. From then on, nothing happens to this saline in the port - it doesn't evaporate, it doesn't mix with blood, it doesn't leak. And this is the condition we have all the time. After six months, too. And after a year, too.

I don't see the point in flushing an unused port after six months - flushing involves injecting a new portion of saline into the port, which has a saline solution. Such an application of the saying "exchanged an axe for a stick". It happened to me several times to flush ports in patients after several months of not using them. Not once have there been any problems with port patency. Problems that may arise are due to the presence of a foreign body in the vein, which is the port catheter, not because there is one or another fluid in the port.

However, if someone wants the port flushed out after 6 months, there is no problem. The procedure for flushing the port takes several minutes. At the ATTIS Center, it is enough to make a telephone appointment (phone 503 119 105) for the date and time of the flushing.

The responsibilities of the personnel using the port are more numerous. Each use of the port should be performed in accordance with existing recommendations.

It is essential for the possibility of long-term use of the port to follow standard hand hygiene procedures and use sterile methods during all activities with the port.

I would like to be understood correctly. It's not that nurses can't disinfect the skin before puncturing the port. Proper functioning of the port is primarily in the interest of the patients, but also in the interest of the nurses and the person who implanted the port. In a group of 2,300 patients I implanted the port, one person developed an infection before using the port (despite the procedures in place), and in two others the infection occurred during the use of the port. This means that the incidence of this complication in this particular group of patients is very low - 0.13%, which in turn means that the nurses are doing a good job.

Any puncture of blood vessels must be a sterile procedure. Before the puncture, it is necessary to ensure that the skin is disinfected for a sufficiently long period of time, such as that specified by the manufacturer of the disinfectant preparation in the Summary of Product Characteristics, and that the area of disinfected skin is large enough to allow the procedure to be carried out freely. For example, for Kodan Tinktur forte, this time is specified at 60 seconds, and Octenisept should not be used at all to disinfect the skin before port puncture. It takes about 8-10 seconds to apply an atomizer or a soaked gauze pad, set them aside, take the needle and puncture the port. This is several times too short a time to sterilize the port puncture area (or the insertion of a venflon, or to prepare, for example, a venflon for IV connection). And if the bacteria don't "die off," they'll do just fine when inserted under the skin or in the blood stream, and two or three days after such "pretend" disinfection can result in, at best, only port pocket infection, fever and other complications. At worst, it could be a decubitus infection including sepsis. This means that the port will not be able to be used, attempts to treat such an infection will rarely be successful in allowing the port to be used, and it will probably have to be removed. Therefore, everyone should take care that a minute passes between the application of disinfectant and the puncture of the port (or forearm vein).

Patients are asked to inform staff of any discomfort or pain they feel while using the port, as the infusion must then be stopped and the cause checked.