Eight‐week interval in flushing and locking port‐a‐cath in cancer patients: A single‐institution experience and systematic review

Port‐a‐cath (PAC) system is one of the most frequently employed venous accesses
for administration of chemotherapy and supportive care. To prevent late complications,
the latest guidelines recommend flushing/locking procedures every four
weeks. In this retrospective study, we evaluate the frequencies of late complications
with a eight‐week flushing/locking procedure compared to the standard one. This
study retrospectively compares the frequency of complications occurred using
standard versus delayed flushing schedules. We performed a systematic review of
the published studies about PAC complications associated with longer flushing intervals.
Three hundred and ninety fully available patients were enrolled. One hundred
and six patients had their PAC flushed/locked every month, 347 patients performed
the flushing/locking procedures every eight weeks, 63 patients switched from the
four to the eight‐week schedule. No difference was seen in the number of occlusions,
infections and mechanical dysfunctions between the two patient groups. The systematic
literature review confirmed, in a total of 1,347 patients, the absence of an
increased proportion of complications with delayed schedules. PAC flushing and
locking every eight weeks are feasible and safe. This delayed schedule may improve
patients’ quality of life and decrease both nursing workload and costs for the national
health system.