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Addressing infection in totally implantable venous access ports : An ex vivo study on bacterial transfer and the Forsvall Port needle design

Pärsson, Håkan LU ; Wagenius, Magnus LU orcid ; Utter, Maria LU orcid ; Tverring, Jonas LU orcid ; Cardoso, José Francisco Pereira LU and Forsvall, Andreas LU orcid (2025) In Journal of Vascular Access
Abstract

BACKGROUND: Totally implantable venous access ports (TIVAPs) are essential for administering chemotherapeutic drugs and nutritional support, but carry a risk of infectious complications. We hypothesized that the design of the current port needle (Huber) could facilitate the collection of bacteria from the skin during puncture, potentially introducing them into TIVAPs and causing infections. This study examines bacterial transfer via needles during TIVAP access and proposes a novel needle design to reduce the risk of infection.

METHODS: A novel needle, the Forsvall Port needle, was developed with a closed tip to reduce bacterial transmission inside the needle during tissue and port penetration. In a randomized ex vivo setting,... (More)

BACKGROUND: Totally implantable venous access ports (TIVAPs) are essential for administering chemotherapeutic drugs and nutritional support, but carry a risk of infectious complications. We hypothesized that the design of the current port needle (Huber) could facilitate the collection of bacteria from the skin during puncture, potentially introducing them into TIVAPs and causing infections. This study examines bacterial transfer via needles during TIVAP access and proposes a novel needle design to reduce the risk of infection.

METHODS: A novel needle, the Forsvall Port needle, was developed with a closed tip to reduce bacterial transmission inside the needle during tissue and port penetration. In a randomized ex vivo setting, human skin samples covered in physiological levels of Staphylococcus aureus were placed over port membranes and punctured repeatedly by the standard Huber needle and the Forsvall Port needle. Cultures from the needle tips were plated after puncture and used to compare bacterial transfer into TIVAPs using a generalized linear mixed-effects model. Punctures were performed in a separate human skin to examine the mechanism of bacterial transfer.

RESULTS: The Forsvall Port needle reduced average bacterial transfer by 87.0% (95% CI: 77.8%-92.4%, p < 0.0001) compared with the Huber needle, based on 10 punctures per needle across four skin samples. Additional testing on a separate skin sample showed that a defectively fitted Forsvall Port needle prototype did not reduce bacterial transfer relative to the Huber needle (95% CI: 58.3% decrease to 30.0% increase, p = 0.289), whereas a steel rod simulating a perfectly closed Forsvall Port needle achieved a 99.9% (95% CI: 99.5%-100%, p < 0.0001) reduction in bacterial transfer.

CONCLUSION: The Forsvall Port needle significantly reduces bacterial transfer into TIVAPs, which could potentially decrease TIVAP-related infections. This study demonstrates a strong association between needle design and bacterial transfer during TIVAP access.

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Contribution to journal
publication status
epub
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in
Journal of Vascular Access
article number
11297298251383741
publisher
Wichtig Publishing Srl
external identifiers
  • pmid:41355206
ISSN
1129-7298
DOI
10.1177/11297298251383741
language
English
LU publication?
yes
id
e9577073-21c2-4247-9edc-2e58c4ab7ea4
date added to LUP
2025-12-08 14:08:35
date last changed
2025-12-08 14:54:52
@article{e9577073-21c2-4247-9edc-2e58c4ab7ea4,
  abstract     = {{<p>BACKGROUND: Totally implantable venous access ports (TIVAPs) are essential for administering chemotherapeutic drugs and nutritional support, but carry a risk of infectious complications. We hypothesized that the design of the current port needle (Huber) could facilitate the collection of bacteria from the skin during puncture, potentially introducing them into TIVAPs and causing infections. This study examines bacterial transfer via needles during TIVAP access and proposes a novel needle design to reduce the risk of infection.</p><p>METHODS: A novel needle, the Forsvall Port needle, was developed with a closed tip to reduce bacterial transmission inside the needle during tissue and port penetration. In a randomized ex vivo setting, human skin samples covered in physiological levels of Staphylococcus aureus were placed over port membranes and punctured repeatedly by the standard Huber needle and the Forsvall Port needle. Cultures from the needle tips were plated after puncture and used to compare bacterial transfer into TIVAPs using a generalized linear mixed-effects model. Punctures were performed in a separate human skin to examine the mechanism of bacterial transfer.</p><p>RESULTS: The Forsvall Port needle reduced average bacterial transfer by 87.0% (95% CI: 77.8%-92.4%, p &lt; 0.0001) compared with the Huber needle, based on 10 punctures per needle across four skin samples. Additional testing on a separate skin sample showed that a defectively fitted Forsvall Port needle prototype did not reduce bacterial transfer relative to the Huber needle (95% CI: 58.3% decrease to 30.0% increase, p = 0.289), whereas a steel rod simulating a perfectly closed Forsvall Port needle achieved a 99.9% (95% CI: 99.5%-100%, p &lt; 0.0001) reduction in bacterial transfer.</p><p>CONCLUSION: The Forsvall Port needle significantly reduces bacterial transfer into TIVAPs, which could potentially decrease TIVAP-related infections. This study demonstrates a strong association between needle design and bacterial transfer during TIVAP access.</p>}},
  author       = {{Pärsson, Håkan and Wagenius, Magnus and Utter, Maria and Tverring, Jonas and Cardoso, José Francisco Pereira and Forsvall, Andreas}},
  issn         = {{1129-7298}},
  language     = {{eng}},
  month        = {{12}},
  publisher    = {{Wichtig Publishing Srl}},
  series       = {{Journal of Vascular Access}},
  title        = {{Addressing infection in totally implantable venous access ports : An ex vivo study on bacterial transfer and the Forsvall Port needle design}},
  url          = {{http://dx.doi.org/10.1177/11297298251383741}},
  doi          = {{10.1177/11297298251383741}},
  year         = {{2025}},
}