What is a port?

A port (also called a mediport or port-a-cath) is a small device implanted under the skin, usually on the upper chest (right or left side). It is approximately the size of a nickel to a quarter and about half an inch thick. Once healed, you may feel a slight raised area under the skin.

A flexible tube called a catheter is connected to the port and tunneled under the skin so that it enters a large vein near the neck. The tip of the catheter is positioned in a central vein near the heart.

The center of the port contains a tough, self-sealing silicone septum. A special non-coring needle (Huber needle) is used to access the port through the skin. After the needle is removed, the silicone reseals instantly.

Why do I need a port?

A port provides reliable, long-term venous access for:

• Frequent blood draws
• Intravenous (IV) medications, including chemotherapy
• IV fluids or nutrition
• Contrast dye for certain imaging studies (if your port is power-injectable)

Patients with ports often say they are relieved that they no longer need repeated needle sticks to find a usable vein. Because the port is completely under the skin when not in use, it is discreet. Once the site has healed, most people return to normal daily activities, including showering and swimming.

What are the risks?

The two most common risks are bleeding and infection. Both are uncommon when proper technique is used.

Bleeding: Please tell our staff if you take blood thinners, aspirin, or aspirin-containing products. We will provide specific instructions about holding these medications before the procedure to minimize bleeding risk.

Infection: Infection related to port placement is rare. We use strict sterile technique and imaging guidance to keep this risk as low as possible.

Other uncommon risks include blood clots, catheter malposition, or (rarely) pneumothorax. Real-time ultrasound and fluoroscopic guidance greatly reduce these risks.

How do I prepare for the port procedure?

• Tell the technologist if you take blood thinners, have any allergies, or are (or may be) pregnant.
• You may take your normal medications (excluding blood thinners or aspirin-containing products as directed) and eat and drink as usual unless our office gives you different instructions.
• You will need to remove clothing from the waist up and any jewelry. A gown will be provided for your comfort and privacy.

The Procedure

You will be taken to the interventional radiology suite. The technologist will cleanse the upper chest and neck with an antiseptic soap. A sterile drape is placed so that only the procedure site is exposed. Every effort is made to keep you comfortable.

The physician injects local numbing medicine under the skin. This may burn for a few seconds; afterward the area is numb. Mild sedation may be offered depending on your needs and the physician’s judgment.

Using real-time ultrasound guidance, a small catheter is placed into a vein in the neck (most often the internal jugular vein). A small pocket is created under the skin approximately 2–3 inches below the collarbone. The port is seated in this pocket. The tubing is connected to the port and tunneled under the skin into the vein. Fluoroscopy (live X-ray) is used to confirm that the catheter tip is in the correct position near the heart.

The pocket is closed with dissolvable (resorbable) sutures and surgical glue. A clear plastic dressing (Tegaderm) is applied. A chest X-ray is obtained after the procedure to document final position.

You will be given an ice pack to take home. Use it for 20 minutes on and 20 minutes off during the first several hours to help with discomfort or bruising. Never place ice directly on the skin—always use a cloth barrier such as a washcloth or T-shirt.

You will also receive a wallet identification card with information about your implanted device. Keep this card with you.

How do I care for the port after placement?

Keep the site dry until it is fully healed.

• You may shower after 24–48 hours if the dressing is protected with plastic wrap or a waterproof cover. Water that runs off the skin is acceptable; do not let a direct stream of water soak the dressing.
• Do not soak in a bathtub, swimming pool, hot tub, or any body of water for 14 days (or until your physician confirms the site is fully healed).
• Leave the original dressing in place and untouched until your one-week follow-up visit, unless you need an infusion before then or the dressing becomes soiled or loose. At the follow-up visit the dressing will be removed and the site assessed.
• Mild pain, bruising, or redness is common for 2–3 days. Over-the-counter pain relievers (as appropriate for you) and the ice pack in the first 24 hours are usually helpful.

Activity restrictions (first week):

• Avoid lifting more than 10 pounds (about a gallon of milk) with the affected arm/side for 3–7 days.
• Avoid strenuous upper-body exercise or movements that pull on the incision until the site has healed.

Long-term care of the port

The port can remain implanted indefinitely. Some patients choose to have it removed after treatment is completed; others keep it for future needs. This decision is made together with your physician.

If the port is not being used regularly, it requires periodic flushing (typically every 4 to 8 weeks, or as directed by your physician) with a special solution to keep it patent. Flushing can be arranged through our office with an order from your doctor, or through your oncology/infusion team.

Signs of infection – call right away

• Extreme or spreading redness
• Pus or drainage from the site
• Increasing pain or tenderness
• Site that is hot to the touch
• Large or increasing swelling
• Fever of 100.4°F (38°C) or higher, or fever over 100°F on two separate readings taken 4 hours apart, with or without chills

When should you call the office?

• Questions about care of the port
• Any of the signs of infection listed above
• Any other concerns about the port site or your recovery

Medical Imaging & Therapeutics

Monday–Friday, 8:00 am – 5:00 pm:  (352) 261-5502

After hours:  (352) 430-7788