What is the recommended duration of use for a Surecan II (central venous access) needle with a Port-a-Cath (implantable venous access device)?

Duration of Surecan II Needle Use for Port-a-Cath

Port access needles should be replaced at least once per week (every 7 days) when used for parenteral nutrition, though the optimal duration for general use remains unresolved in major guidelines. 1

Guideline Recommendations

For Parenteral Nutrition (PN) Use

• The ESPEN guideline explicitly recommends replacing port needles at least once weekly when administering home parenteral nutrition 1
• This weekly replacement schedule provides an opportunity for patients to safely bathe or shower when the needle is temporarily removed 1
• The more frequent replacement with PN is justified by the higher risk of colonization of administration sets with parenteral nutrition solutions 1

For General Port Access

• The CDC guidelines classify the optimal timeframe for replacing port access needles as an "unresolved issue" - meaning no definitive recommendation exists for non-PN use 1
• One retrospective study demonstrated that weekly needle changes with transparent dressings appears safe and cost-effective, though patients on PN had significantly greater infection risk from Candida species 1
• Conversely, a study in patients receiving continuous chemotherapy showed needles remained in place for an average of 28 days without adverse effects 1

Clinical Decision Algorithm

For patients receiving parenteral nutrition:

• Replace needle every 7 days (maximum) 1

For patients receiving chemotherapy or other infusions (non-PN):

• While guidelines don't mandate a specific interval, the balance of evidence suggests:
  • 7-day replacement is the safest approach based on PN data 1
  • Up to 28 days may be acceptable in select chemotherapy patients based on limited evidence 1
  • I recommend defaulting to weekly (7-day) replacement to minimize infection risk, particularly with Candida species 1

Critical Maintenance Requirements

Regardless of needle duration, proper port maintenance requires:

• Scrubbing the access port with appropriate antiseptic (chlorhexidine-alcohol for 15 seconds, or 70% alcohol) before each access 1
• Using only sterile devices to access the port 1
• Flushing ports monthly when not in active use to maintain patency 2
• Normal saline is equally effective as heparin (100 U/mL) for maintaining port patency 2

Common Pitfalls to Avoid

• Do not leave needles in place longer than 7 days when administering PN - this significantly increases infection risk 1
• Avoid assuming longer dwell times are safe just because one study showed 28-day use - that evidence is limited to specific chemotherapy contexts 1
• The lack of a firm CDC recommendation does not mean needles can remain indefinitely - err on the side of weekly replacement 1