Ports (Medports or Subcutaneous infusion ports)

What is a Port?

A port is similar to other long-term IV lines (BROVIAC® catheter), however, the entire device is buried under the skin. Ports allow a soft IV catheter to be placed in your child and are generally used in patients who require IV access for more than 3 months. A Port is placed directly into a central vein, usually in the neck or upper chest. The catheter proceeds to a position just above the heart. The catheter is then tunneled under the skin and the port is then secured against the chest wall through a separate incision (usually 1 to 2 inches in length). Each time the device is needed, it must be accessed via a special needle (Huber needle).

What are the advantages and disadvantages of a Port over a BROVIAC® Catheter?

One advantages of a Port is that it is completely implanted under the skin. Studies have shown that this is associated with a lower infection rate compared to BROVIAC® catheters. Additionally, the Port is more stable, with a lower chance of getting displaced (catheter coming out of the vein).

The disadvantage of the Port is that it leaves a larger scar on the chest than a BROVIAC® catheter. Additionally, each time a Port is needed, it must be accessed with a needle stick. In general, a numbing cream (Emlaš) can be used, and should be applied at least 30 minutes before the Port is accessed.

Why is a Port needed?

Some children have IV needs that exceed what a PICC can do. Some may need a catheter for a prolonged period of time - generally greater than 3 months. Others may have a need for extensive blood draws for laboratory tests that may exceed what a PICC can do. Finally, some children may not have large enough peripheral veins to allow for a PICC line.

How is a Port placed?

Unlike a PICC line, Ports are placed in an operating room setting. A surgeon will place such a line. Your child will most likely undergo a general anesthetic (completely asleep) when the BROVIAC® catheter is inserted. This is important, as there is more pain and discomfort when this catheter is placed. Additionally, the surgeon will need to use X-rays (fluoroscopy) while placing the line - something which can't be done at the bedside. In general, a prescription for a pain medication may be given for your child (often Tylenol (acetaminophen) with Codeine elixir or tablets). This prescription pain medication can be used for the first couple of days until the pain subsides. Importantly, do not mix this Tylenol with Codeine with regular Tylenol as this could be harmful to your child).

How do I care for my Port?

Prior to your use of the Port a nurse will give you instructions on its use. If your child will be admitted or will use the University of Michigan home infusion group (HomeMed), this will be done prior to you going home. If you use another infusion company, training will occur at home by a home healthcare nurse, and should be arraigned prior to you taking your child home.

"What will it look like?"

After the procedure is finished, a sterile dressing will be placed over the area where the Port has been placed under your child's skin. While the Port is accessed, this dressing is an important barrier to prevent infection and you will be taught how to change this dressing. An additional small dressing (steristrip) will be placed on the chest or neck where the catheter is entering the vein; this steristrip will fall off in 7 to 10 days and need not be replaced.

Removal of the Port

In general, a Port needs to be removed with a general anesthesia. This will require a visit to hospital as an outpatient. The procedure itself last only a few moments. A light dressing will be placed over the site where the Port was. This should stay clean and dry for 2 days and then may get wet in a bath or shower. The dressing will fall off in 7 to 10 days. Because it is a see-through dressing, don't be surprised if you see a few drops of blood on the dressing. The area will generally be numbed with a long acting medication like Novacaine (Marcaine). Tylenol or Children's Motrin (according to their age and weight) may be used for pain.

Important reference information

Use the following chart to record information about your child's home care company and catheter.

This information is provided by the University of Michigan Department of Surgery, Section of Pediatric Surgery and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. For additional health information, please contact your health care provider or our offices.

HICKMAN and BROVIAC are registered trademarks of C. R. Bard, Inc. and its related company, BCR, Inc.