Burden of complications from needle penetration of plastic ports in children

J Pediatr Surg. 2014 May;49(5):763-5. doi: 10.1016/j.jpedsurg.2014.02.061. Epub 2014 Feb 22.

Abstract

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.

Keywords: Children; Complications; Portacath; Vascular access device.

MeSH terms

  • Catheterization, Central Venous / adverse effects
  • Catheterization, Central Venous / instrumentation
  • Child
  • Child, Preschool
  • Equipment Design
  • Equipment Failure*
  • Extravasation of Diagnostic and Therapeutic Materials / etiology
  • Female
  • Foreign-Body Migration / etiology
  • Humans
  • Infections / etiology
  • Male
  • Needles*
  • Pain / etiology
  • Plastics
  • Retrospective Studies
  • Time Factors
  • Vascular Access Devices / adverse effects*

Substances

  • Plastics