Clinical Procedure
 
Aliases:
Broviac removal

Topic aliases are alternate phrasings for a particular topic.


Broviac lines that have been in for more than a week usually require gentle dissection around the tissue cuff to allow for their removal.

Local or general anaesthesia is usually required for this.

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Lines 4.2 or smaller are more fragile and more like to break on removal, and so should be more carefully removed.

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You want to avoid the abrupt "snapping" of the line as the last attachment of the tissue cuff is blunt dissected away under tension.

This increases the risk that the line may break, particularly at its insertion at the central vein.

For the part of the blunt dissection where the last part of the cuff is being separated consider reducing the tension on the line

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Ensure any anticoagulants have been appropriately ceased and, if at risk, coagulopathy has been ruled out.

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Look at the record of the line's insertion to note any difficulties with insertion or unusual passages of the the lines.

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Discuss :
- Risk of site infection
- Risk of breakage of the line (usually only a risk in lines 4.2 or smaller )
- Possibility of a suture or just steristrips to appose the small hole.
- Padded dressing that can come off in 2 days
- Parent should let somebody know if the padded dressing becomes soaked with blood.
- Call if the site looks infected at any time.

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10-30 minutes

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IV access separate to the broviac will be required if general anaesthesia is being administered.

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Can be performed under local or general anaesthesia.

Local anaesthesia is usually appropriate for adults and ocassionally for infants.

General anaesthesia is usually appropriate in children.

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Infiltrating with local anaesthetic with adrenaline (eg marcaine with 1:200,000 adrenaline ) will help minimise bleeding during the blunt dissection around the tissue cuff.

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