Risk factors associated with surgical site infection and the development of short‐term complications in macaques undergoing indwelling vascular access port placement

Abstract

Vascular access ports have a moderate risk of complications, provided the surgical program optimizes best practices. Under complex experimental conditions, VAPs represent an important refinement, both improving animals' overall well-being and environment and reducing stress.

A novel alternative placement site and technique for totally implantable vascular access ports in non‐human primates

“…We developed the SIPI approach, with either saphenous vein puncture or saphenous vein cutdown, to avoid many of the challenges of JVC and FVC (Table 3). Infectious complications associated with JVC/FVC ranges between 13% and 30% [12,14,22,23] and those for jacket and tether systems between 25% and 30% [24,25]. The overall rate of infection for SIPI found in the present study, 8.6%, is substantially lower.…”

“…The two traditional methods of VAP implantation in NHPs are jugular venous cutdown (JVC) and tunnel, and femoral venous cutdown (FVC) and tunnel [1, 12, 13]. Previously, we employed the FVC approach, making a longitudinal incision below the inguinal ligament to access the femoral vein and tunneling the catheter to a second incision housing the port on the posterior chest wall [14]. The relative invasiveness of two separate incisions with a lengthy tunnel requires general anesthesia.…”

“…The relative invasiveness of two separate incisions with a lengthy tunnel requires general anesthesia. Also, complications are common and include infections, mechanical occlusion, thrombotic occlusion, dehiscence or erosion, and even death [1,4,7,10,12,[14][15][16][17]. Postural movement of the NHP can restrict the catheter (at the hip joint in FVC or bending acutely at the port head in JVC), resulting in mechanical failure [1].…”

“…Postural movement of the NHP can restrict the catheter (at the hip joint in FVC or bending acutely at the port head in JVC), resulting in mechanical failure [1]. Ordinary tension placed on an inguinal incision during normal movement is associated with post‐operative irritation and discomfort [14]. The inguinal region is expected to have higher bacterial densities and potential for infection than other sites [18, 19].…”

Successful implementation of cooperative handling eliminates the need for restraint in a complex non‐human primate disease model

“…Prior to June 2006, comprising 28 animals, there was no formal training program, and animals were instrumented using the traditional surgical method for vascular access port (VAP) placement [19]. In these animals, chemical or chair restraint was used for handling.…”