Subcutaneous Port

What is a subcutaneous port?

A subcutaneous port is a long, thin tube (catheter) that provides long-term venous (vein) access. It is a type of central venous catheter (central line) that is placed completely under the skin, usually in the chest. The port looks like a small disc with a raised center. A catheter runs from the port into a large vein near your child’s heart. 

A port is sometimes known as a port-a-cath, implantable port, or subcutaneous infusaport, subQ port, or implantable venous access device (IVAD). It allows medicines, nutrition, blood products, and fluids to be given to your child. Blood samples can also be taken.  

With good care, the port can stay in place for months to years before it needs to be removed. It is important to take care of the port and follow all instructions to prevent infection and keep it working properly. 

How a subcutaneous port works

The care team makes a small incision to place the port and catheter under the skin. They guide the catheter until it reaches a large vein near the heart. The skin is closed over the port. 

The center of the port, called a septum, is a raised area made of rubber. Medicines or other fluids are injected into the septum and travel through the central line to the vein. Medicine is given through the port using a special needle, called a Huber needle. A numbing cream can be used over the area before needle sticks.  

The port may have 1 or 2 access points (single lumen or double lumen). A lumen is an opening or channel through which medicines and fluids can be given. 

Benefits of a subcutaneous port

Benefits of a subcutaneous port include:

• A subcutaneous port reduces the need for needle sticks for medicines, fluids, nutrition, blood products, and blood samples. However, a needle is still used to access the port.
• This type of central line is located completely under the skin without any tubing outside of the body.
• A port can stay in place for a long time.
• Some medicines can irritate your child’s smaller blood vessels. A port is placed in a large vein with high blood flow, so there is less irritation.
• You can give your child medicine through a subcutaneous port at home, making it easier for your child to continue therapy.
• With some types of ports, you can give more than 1 type of medicine or liquid at the same time.
• Less maintenance and care are needed for a port because it is located completely under the skin.
• The long-term risk of infection with a port is lower than with other types of central lines.
• Your child may bathe and swim with a port if their health permits and if your care team says it is OK.

How a subcutaneous port is placed

Knowing what to expect can help you and your child feel more comfortable before and during port placement.

Your child will have general anesthesia for port placement. This means your child will not feel pain or be aware during the procedure. It is important to follow NPO instructions about when your child must stop eating and drinking before the procedure. The entire process, including anesthesia and recovery, usually takes about 1–2 hours.

Risks of a subcutaneous port

Every medical procedure has some risks, including those that involve anesthesia and surgery. Your child’s care team takes steps to keep these risks as low as possible. 

Risks during subcutaneous port placement 

While the port is being placed, possible risks include: 

• Puncture of a blood vessel 
• Bruising or bleeding 
• Damage to nearby structures or organs 
• Insertion into the wrong vein 
• Blood clots forming in the vein 
• Air in the blood 
• Irregular heartbeat 
• Nerve injury 
• Infection 
• Allergic reaction to medicines or contrast (x-ray dye) if used 

Risks after subcutaneous port placement 

Possible complications include: 

• Blood clots 
• Swelling 
• Infection 
• Skin problems around the port 
• Discomfort 
• Blocked port 
• Leakage 
• Lung collapse (pneumothorax) - rare 

Important information  

Serious problems are rare, but they can happen. Always ask questions if you are unsure about any part of the procedure. Follow all instructions from your child’s care team. 

How to care for a subcutaneous port

Your care team will teach you how to care for the subcutaneous port. Always follow your care team’s instructions to keep the line working properly and take steps to prevent infection.  

Early healing 

The area will be sore for a few days. There will be medical glue where the cut was made. There may be some swelling or bruising in the area. Your child can return to most usual daily activities as they feel up to it.   

Accessing the port 

During treatment (giving medicines), a Huber needle is used to access the port. Your child may feel a “poke” with the needle stick. Numbing cream, freeze spray, Buzzy®, or other pain management strategies may be used. When the port is not in use, the needle is removed, and your child can do most daily activities. 

Medicines can be given with a syringe or an IV bag. Let your care team know if your child has any pain or discomfort while getting medicines. 

The port must be flushed every 4 weeks with heparin. Heparin is a medicine that keeps the blood from clotting and blocking the line.  

Living with a subcutaneous port

Your child will wear a dressing over the area when the needle is in place. The dressing must be kept clean and dry.  

Avoid activities such as contact sports or rough play that might cause impact to the port area.  

Protect the skin around the port from seat belts by placing a soft pad over your child’s chest.  

Your care team may give you a card with information about your port. Keep this card with you at all times. Tell your child’s teachers, school nurses, and caretakers about the port.  

Preventing infection

Patients with a port are at risk for a serious infection known as central line-associated blood stream infection (CLABSI), which can be life-threatening. To help prevent infection: 

• Always wash your hands before and after doing any line care. 
• Keep the central line site clean and dry. 
• Make sure the dressing is changed every 7 days or more often as needed if it gets wet, dirty, or loose. 
• Make sure your child bathes and changes clothing daily. 
• Change your child’s bed linens once a week, or more often if they are soiled. 
• Practice good oral care to reduce mouth bacteria, including brushing teeth twice a day. 
• Seek medical care right away at any sign of infection, such as pain, redness, swelling, drainage, or fever.  

When to call your care team

Call your care team if you notice any of the following: 

• Redness, pain, drainage, warmth, or swelling at the port site that gets worse or does not get better in 24 hours
• Swelling in the face, neck, shoulder, chest, or arm on the side of the body where the port is inserted
• Fever (follow fever guidelines given by your care team)
• Chills, nausea, weakness, chest pain, shortness of breath, fast heartbeat, dizziness, or confusion
• Problems using the port

Questions to ask your care team

• Why does my child need a subcutaneous port?
• How long will my child need an implanted port?
• What can I expect before, during, and after getting a port?
• How often do I need to perform line care activities?
• How is needlestick pain managed?
• Can my child shower or bathe while they have a port?
• What activities should my child not do with a port?
• Are there any long-term effects of a port?
• How will I know if my child has an infection?
• When should I call the care team?

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