Dermal securement of port catheters in obese patients

Space: StayCurrentMD Author: Kara A Rothenberg, Rebecca C Gologorsky, Sunghoon Kim Published:

Author / Expert

Kara A Rothenberg, Rebecca C Gologorsky, Sunghoon Kim

Topic overview

Abstract

Background

Port catheters are often used for patients who require long-term central venous access. However, thick subcutaneous fat may obscure the port location and limit the degree to which the port is palpable. We describe a method to improve port catheter placement in overweight and obese patients.

Methods

Port catheters were placed in three overweight and obese patients after a diagnosis of malignancy. Rather than securing the port onto muscular fascia as is typically done, securing sutures were directed toward the dermis, elevating the port toward the skin and creating skin dimpling for visual reference.

Results

There were no intra- or postoperative complications. The ports remain visible and palpable >9 months after placement and there have been no reported difficulties with access.

Conclusion

This method improves visualization of the port location and facilitates palpation of the port during Huber needle access.

Keywords

port cathetersobesitycentral venous accesssurgical techniquepediatric surgerymalignancydermal securement

Hashtags

#pediatricsurgery#central_venous_access#obesity_management
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Title: Dermal securement of port catheters in obese patients 1. J Pediatr Surg. 2020 Mar;55(3):570-572. doi: 10.1016/j.jpedsurg.2019.09.013. Epub 2019 Nov 1. Dermal securement of port catheters in obese patients. Rothenberg KA(1), Gologorsky RC(1), Kim S(2). Author information: (1)Department of Surgery, University of California San Francisco-East Bay, Oakland, California. (2)Division of Pediatric Surgery, UCSF Benioff Children's Hospitals, Oakland, California. Electronic address: sunghoon.kim@ucsf.edu. BACKGROUND: Port catheters are often used for patients who require long-term central venous access. However, thick subcutaneous fat may obscure the port location and limit the degree to which the port is palpable. We describe a method to improve port catheter placement in overweight and obese patients. METHODS: Port catheters were placed in three overweight and obese patients after a diagnosis of malignancy. Rather than securing the port onto muscular fascia as is typically done, securing sutures were directed toward the dermis, elevating the port toward the skin and creating skin dimpling for visual reference. RESULTS: There were no intra- or postoperative complications. The ports remain visible and palpable >9 months after placement and there have been no reported difficulties with access. CONCLUSION: This method improves visualization of the port location and facilitates palpation of the port during Huber needle access. Copyright © 2019 Elsevier Inc. All rights reserved. DOI: 10.1016/j.jpedsurg.2019.09.013 PMID: 31727382 [Indexed for MEDLINE]

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