When to implant a port after removing the previous one because of infection

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“We conducted a retrospective bicentric study including all patients having undergone PAC removal because of infection, followed by re-implantation of a new one in the next month, between 2004 and 2012.” Simoné et al (2014).

Reference:

Simoné, G., Piroth, L., Lakkis, Z., Rat, P., Heyd, B. and Ortega-Deballon, P. (2014) Delay before implanting a port-a-cath after removing the previous one because of infection. Médecine et maladies infectieuses. 44(7), p.315-20.

Abstract:

AIMS: We had for objective to assess the risk of a new Port-a-Cath (PAC) infection after re-implantation when the first one had been removed because of infection in the previous month.

METHODS: We conducted a retrospective bicentric study including all patients having undergone PAC removal because of infection, followed by re-implantation of a new one in the next month, between 2004 and 2012.

RESULT: One hundred and forty-nine PAC removals were followed by re-implantation in the next month. The cause of removal was infection for 63 patients: 34 presented with bacteremia (13 PAC removals and simultaneous re-implantation, and 21 with delayed re-implantation for a mean 14days) and 29 presented with local signs of infection (20 PAC removals and simultaneous re-implantation, and with delayed re-implantation for a mean 13days). Two out of 13 PACs were re-infected in the bacteremia group, (15.4%) when the removal and re-implantation were performed simultaneously, and 1 out of 21 (4.8%) when re-implantation of the second PAC was delayed. The 3 re-infected PACs were successfully treated with antibiotics.

CONCLUSION: The early re-implantation of a PAC after removal of the previous one because of infection is a relatively safe procedure. The risk of infection can be higher when PAC removal and re-implantation are performed simultaneously in patients presenting with bacteremia; nevertheless, all reinfections were successfully treated with antibiotics.

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