Needle Dwell Time for B. Braun Port-a-Cath Access
Current guidelines do not establish a specific maximum dwell time for needles used to access implantable ports, including B. Braun Port-a-Cath systems, leaving this as an unresolved clinical question. 1
Guideline Recommendations
The CDC/HICPAC guidelines explicitly state: "No recommendation can be made regarding the length of time a needle used to access implanted ports can remain in place" - this remains an unresolved issue in infection prevention. 1
Standard Clinical Practice
Despite the lack of evidence-based guidelines, the following practices are commonly employed:
Huber needles (non-coring needles) used to access ports are typically changed every 7 days when the port is being used for continuous infusion therapy. 1
The needle change interval aligns with administration set replacement recommendations, which specify replacement at least every 7 days for continuously used sets. 1
For intermittent access (such as periodic chemotherapy administration), the needle is removed after each treatment session rather than left in place. 2
Port Maintenance Without Active Access
When the port is not actively being accessed with a needle:
The European Society for Medical Oncology (ESMO) recommends flushing subcutaneous ports every 4 weeks with normal saline when not in active use. 2
Research suggests that monthly maintenance is adequate to maintain catheter patency, with some studies showing safe intervals up to 90 days between flushes. 3, 4
Key Clinical Considerations
Infection risk management:
Minimize contamination by scrubbing the access port with appropriate antiseptic (chlorhexidine, povidone iodine, or 70% alcohol) before accessing with sterile devices. 1
Ports have lower catheter-related bloodstream infection rates compared to tunneled and non-tunneled central venous catheters. 1
Practical limitations:
The 7-day needle change interval balances infection risk with patient comfort and the need to minimize repeated needle insertions through the port septum. 1
Repeated needle punctures can eventually damage the port septum, though modern ports are designed to withstand approximately 2,000 punctures. 4
Common Pitfalls to Avoid
Do not leave accessing needles in place indefinitely during continuous therapy - establish a regular 7-day change schedule. 1
Do not use needles smaller than recommended or non-Huber needles, as these can damage the port septum and cause leakage. 2
Always use a 10 mL or larger syringe when flushing to prevent excessive catheter pressure that can cause damage. 2