Delay before implanting a port-a-cath after removing the previous one because of infection

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 14 days) and 29 presented with local signs of infection (20 PAC removals and simultaneous re-implantation, and with delayed re-implantation for a mean 13 days). 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. (C) 2014 Elsevier Masson SAS. All rights reserved.