Rare advanced complication of an infusion port with pocket skin necrosis successfully preserve the port : a case report

The totally implantable venous access port (TIVAP) is widely recommended for patients requiring chemotherapy, total parenteral nutrition, or long-term antibiotic therapy. Nevertheless, pocket skin necrosis, albeit infrequent, represents a potential complication that may progress to more severe adverse outcomes. A 55-year-old female patient with a history of breast cancer developed localized skin thinning at the infusion port site six months after completing adjuvant chemotherapy. Over the subsequent seven months, conservative management was implemented; however, the patient later presented with skin necrosis and exposure at the site, accompanied by localized pain. To address this, a new pocket was created adjacent to the original site, and the puncture hub was relocated within the new pocket. Following this intervention, the patient successfully completed her treatment course. Proactive preparation of the local pocket skin may help mitigate the risk of pocket skin necrosis. In cases where necrosis occurs, creating an adjacent new pocket for hub relocation constitutes an effective approach for management and preservation of treatment continuity.