When undergoing long-term medical treatment, patients often worry about maintaining normal daily activities like swimming, especially with an implanted port (portacath). This device is placed for extended care, raising questions about water safety and immersion. This article clarifies the necessary conditions and precautions for safely returning to water activities. Understanding the device and following specific hygiene protocols are key to safely resuming an active lifestyle.
What is an Implanted Portacath?
A portacath, or totally implanted venous access device (TIVAD), is a central venous access device. This system consists of two main components: a small reservoir (the port) and a flexible tube (the catheter). The port is typically situated underneath the skin in the upper chest, just below the collarbone.
The catheter is surgically threaded from the port into a large, central vein, often the superior vena cava near the heart. This placement allows for the reliable delivery of medications, such as chemotherapy or antibiotics, and facilitates easy blood draws over many months or years. Since the entire device is housed beneath the skin, the risk of external contamination is minimized, making swimming possible.
Safety Guidelines for Swimming and Water Immersion
Swimming is generally permissible with a portacath if two conditions are met: the surgical insertion site must be fully healed, and the port must be unaccessed. Healing usually takes a minimum of seven to fourteen days, but a physician must confirm the incision sites are completely closed before immersion. A port is “accessed” when a Huber needle is inserted for treatment, and swimming is prohibited while the needle is in place.
The risk of infection is the main concern with any central access device, and this risk is influenced by the water source. Well-maintained, properly chlorinated swimming pools and clean ocean water are considered lower-risk environments for a healed port. Patients must actively avoid high-risk water types due to increased concentrations of bacteria and microorganisms, which can cause a bloodstream infection. High-risk water sources include:
- Lakes
- Ponds
- Rivers
- Hot tubs or jacuzzis
Essential Steps for Protecting the Port Site
To safely engage in water activities, patients should apply specialized protective measures even with a completely healed, unaccessed port. The most reliable method involves using a large, impermeable, waterproof dressing or barrier designed for central line protection. These coverings must be applied meticulously over the port site to create a secure, occlusive seal against the skin. The dressing should be checked for any lifted edges or creases before entering the water to ensure a complete barrier is maintained throughout the activity.
Immediately upon exiting the water, the waterproof barrier must be removed to prevent moisture from becoming trapped against the skin, which can promote bacterial growth. The port site and the surrounding skin should be thoroughly dried using a clean towel in a gentle dabbing motion. Patients should then perform a careful visual inspection of the port area, checking for any subtle changes in the skin’s appearance or texture. If any moisture is suspected to have penetrated the dressing or if the area feels damp, the patient should perform site care as instructed by their clinical team.
It is advisable to discuss specific commercially available waterproof products with the treating physician or nurse, as they can recommend the most effective barrier for the individual’s port location and skin type. Consistent communication with the healthcare provider about activity plans ensures that the necessary preventative steps are integrated into the patient’s overall care plan.
Recognizing and Responding to Infection Risks
Infection is the most serious complication associated with a portacath, and water exposure can heighten this risk by introducing pathogens to the surrounding skin. Patients must remain vigilant for localized signs of infection at the port site, which include:
- New or increasing redness (erythema)
- Swelling
- Tenderness upon touching the area
- Increased warmth over the port pocket
- Induration (hardening of the tissue)
- Any form of drainage, such as purulent discharge or clear fluid leakage
Systemic signs of infection indicate a potential bloodstream infection and require immediate medical intervention. These symptoms include the sudden onset of a fever (above 37.5 degrees Celsius) or experiencing chills. Any unexpected feeling of being generally unwell, or more severe signs such as hypotension, should prompt an urgent call to the patient’s care team or immediate presentation to an emergency department. Prompt reporting of these symptoms allows for quick diagnosis and treatment with antibiotics, which is often necessary to prevent device removal.