Portacath Removal | IntraCare

Procedures

Procedures › Portacath Removal

About this procedure

This guide provides information about a portacath removal procedure. It includes details about what is involved, how to prepare and what to expect during and after the procedure. Please use this in addition to information from your doctor and nurse.

A portacath (port) is removed in an interventional radiology suite at IntraCare in Epsom. Your interventional radiologist or vascular surgeon will be assisted by our team of nurses and other highly skilled personnel.

Before the procedure

Pre-procedure phone call

A nurse from IntraCare will call you 24–48 hours prior to your procedure to discuss the following information:

Your admission time.
When you should stop eating and drinking.
Medication instructions.
Allergies (including medications, contrast dye, dressings/plasters and food).
Answer any further questions.

Anticoagulation (blood thinner)

If you are taking any blood thinners (e.g. Warfarin, Clexane, Pradaxa, Rivaroxaban), please make this known to IntraCare staff at the time of booking. Your interventional radiologist or oncologist will advise you if you need to stop this medication temporarily for a few days before the procedure.

Other regular medications

Please continue to take these unless advised otherwise by your interventional radiologist, surgeon or oncologist. If you are taking a diuretic or water pills (e.g. frusemide, spironolactone), you may need to withhold this on the morning of the procedure.

Reminders for the day of your procedure

If you are on regular medication, please bring this with you in its original packaging.
Please leave all your jewellery and valuables at home. You are welcome to bring your mobile phone in with you.
We recommend wearing loose-fitting clothing and shoes that are easy to slip on/off.
You are encouraged to bring a friend or a family member as a support person before and after your procedure.
Please arrange for someone to drive you home after the procedure as you will not be able to drive for 24 hours following your procedure.
The planned procedure time is an estimate only and may vary. We will keep you informed of any unexpected delays on the day.

Informed consent

As with any procedure, there are potential risks involved. Your interventional radiologist or vascular surgeon will explain the procedure, discuss possible risks and answer any questions you may have. Your whānau or support person are welcome to be part of this discussion. You will then be asked to sign the consent form. This will occur either at an earlier appointment, or on the day of your procedure.

Your procedure

A portacath removal procedure is performed under conscious sedation and usually takes 30–45 minutes.

Preparation

We may need to remove hair with clippers at the access site for sterile preparation. Please avoid shaving the area yourself as this may cause minor abrasions to the skin, increasing the risk of infection.

Other devices for monitoring blood pressure, heart rate and oxygen levels will be fitted to ensure your safety during the procedure.

The procedure

The chest area where the port is inserted will be cleaned with an antiseptic solution. You will be covered with a large sterile drape to ensure sterility is maintained. The doctor will then administer medication via your portacath to help you relax and keep you comfortable.

Local anaesthetic is then used to completely numb the area around your port. This will sting a little as the local anaesthetic goes in. Once the area is numb, the doctor will make a small incision over the port. The port is freed from any tissue and the entire device is removed, including the catheter.

You may feel pressure while the port is removed. If at any time you feel pain or are uncomfortable, please let your doctor know. More local anaesthetic or medication can be given to help you relax.

The incision (wound) will be closed with dissolvable stitches and steri-strips. Sometimes surgical glue is used. The area is then covered with a water resistant dressing.

After your procedure

You will be taken to recovery where you will be given something to eat and drink. The nursing team will monitor your recovery and if appropriate you will be discharged after one hour. Prior to your discharge, the nurses will provide instructions on medication, procedure site care, and resuming your usual daily activities.

Recovery and discharge

Following your procedure, it is important that you do not drive for 24 hours.
Please ensure you have a family member or friend to drive you home from the hospital, as you may still be under the effects of sedation.
You will need to arrange for someone to be at home with you on the day of your discharge and overnight to support you in your recovery.
Due to the sedation, you may feel lethargic afterwards with reduced concentration. For this reason, for 24 hours after your procedure:
- Do not do any activity requiring strength, concentration, or full alertness.
- Do not make any legal decisions or sign legal documents.
Following the procedure you may have some tenderness, bruising or discomfort at the incision site. This is usually managed with oral pain medication such as paracetamol. The discomfort should settle after 2–3 days.

Resuming activities

Do not do any exercises that involve forceful reaching or stretching as these can ‘pull’ the stitches and delay the wound (incision) healing process.
Avoid participating in any strenuous exercise such as golf, tennis, swimming, or aerobics while your incision is healing.
It is important not to lift your arm above shoulder height or lift any heavy objects (>5kg) for 2 weeks.

Medication

Your interventional radiologist or vascular surgeon may give you a prescription for pain relief (analgesic) to take home. Please use this should you experience any dull aching pain for the following few days.

Follow-up

A nurse from IntraCare will contact you 2–3 days after the procedure to check you are well and answer any questions you may have. Please contact IntraCare if you have any concerns prior to this call.

Wound care (incision site)

The sutures used to close the skin incision will dissolve over 7–10 days. Please keep the dressing in place for 7–10 days or until you notice the sutures have dissolved.

You will be supplied with extra dressings on discharge. If you have sensitive skin or a sensitivity to dressings, please inform the nurse so we can arrange an alternative.

The goal of wound care management is to reduce the frequency of dressing changes. This helps prevent the risk of contamination and infection. The dressings supplied are water resistant, but not waterproof:

Please avoid baths, spas or swimming while the wound is healing.
You can shower, but please have your back towards the water.
Always inspect the dressing before you get in the shower to check the edges are sealed. If you notice the dressing beginning to lift at the edge, anchor it back down with another dressing (see image below).

Change the dressing if:

It becomes wet or compromised.
Has peeled back and the white area is exposed to air.
It becomes heavily soiled with blood (superficial spots of blood on the dressing are normal).
You develop a reaction to the dressing (please contact IntraCare before removing the dressing).

When removing the dressing:

Please wash your hands and avoid touching the incision site.
If skin glue was used, this will peel off by itself in 10–15 days. Please avoid removing it.
If steri-strips (white strips) were used, please avoid peeling them off.
Do not use any ointments, soap or creams on the wound during the healing phase.

Contact your doctor if you have any of the following:

Swelling
Bleeding
Redness
Leaking of fluid or pus
Pain
Temperature greater than 38.5 degrees
Extensive bruising

Seek immediate medical attention (dial 111 for an ambulance) if there is excessive bleeding from the puncture site or if you are experiencing severe chest pain.

Please show this page and your discharge summary if visiting a GP, after-hours or hospital.

In case of emergency, always call 111.

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