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Published on: July 13, 2019
Burden of complications from needle penetration of plastic ports in children
Nicole E Sharp1, E Marty Knott1, Priscilla Thomas1
1The Children's Mercy Hospital, Kansas City, MO.
Insights
Plastic ports pose a high risk for needle penetration, with 6.8% of plastic ports experiencing posterior wall perforation. Utilizing ports with metal backing is recommended to prevent this complication.
Area of Science:
- Medical Devices
- Pediatric Surgery
- Vascular Access
Background:
- Totally implanted venous access ports are common in pediatric care.
- Mechanical complications, including posterior port penetration by access needles, are a concern.
- This study addresses the incidence and characteristics of posterior penetrations.
Purpose of the Study:
- To investigate the frequency and burden of posterior penetrations of totally implanted venous access ports.
- To identify risk factors associated with posterior port penetrations.
Main Methods:
- A retrospective review of venous access ports placed between November 2007 and December 2011 was conducted.
- Data from 247 pediatric patients were analyzed.
Main Results:
- Posterior port penetrations occurred in 8 patients (3.2% overall), exclusively in plastic ports (6.8% of plastic ports).
- All perforations involved plastic ports of a single brand and product code.
- Other complications included catheter malfunction, infection, and pain.
Conclusions:
- Plastic ports demonstrate an unacceptably high risk of posterior needle penetration.
- Ports with metal backing are recommended to mitigate this specific complication.
Background:
Complications of totally implanted venous access ports are well documented. A concerning mechanical complication we have encountered is posterior penetration of plastic ports with the access needle. The purpose of this study is to investigate the burden of posterior penetrations.
Methods:
We performed a retrospective review of all ports placed between November 2007 and December 2011 at a single institution.
Results:
There were 247 children who received a port. 117 children (47%) received a port with a plastic posterior wall, 95 children (38%) received a port with a metal posterior wall, and 35 children (14%) had ports that were unable to be identified as plastic or metal. Posterior port penetrations occurred 8 times (3.2% overall, 6.8% of plastic ports). All perforations occurred in plastic ports of a single brand and product code. Average time from port insertion to penetration was 11.2±21.3 months (range 0.3 to 63.4 months). Other complications included catheter malfunction (14), infection (9), pain (2), inability to draw/aspirate (4), leak (3), port migration (2), and malfunctioning not otherwise specified (15).
Conclusions:
There is an unacceptably high risk of needle penetration of the posterior wall of plastic ports. We recommend utilizing ports with metal backing to avoid this complication.
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