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Re: [IP] question on ports

     >I was just goiong threw Disetronics web site and found the Diaport 
     >and the Percuseal Port and was wondering what everyone else thought 
     >of these?
     While Diesetronic says that the trials for these "permanent" infusion 
     ports are going well, I am still a bit skeptical.  The design for the 
     Diaport is identical to some titanium/silicone devices that were 
     designed for peritoneal dialysis (and really didn't work) a LONG time 
     ago.  The big issues are:
     1) anything sticking out through the skin will likely eventually have 
     problems with a critical infection.  "Sucess" in this area depends on 
     what infection rate you find acceptable - 1/year, 1 per 2 years?  
     Serious infection requires removal/replacement of the device.
     2) using a catheter device to administer insulin into the peritoneal 
     cavity often causes either fibrin blockage or entrapment by the 
     omentum (bet you haven't studied THAT organ yet!)
     3) using a catheter device to administer directly into a vein also has 
     its own complications.
     Unless the designers have come up with some major improvements in the 
     areas above, I still prefer changing a flexible cannula every 3-3.5 
     days.  Not to disappoint anyone, but you'll find evidence of issues 2) 
     and 3) in some published trials of implantable pumps.  If I remember 
     correctly, the fibrin blockage resulted in removal/replacement of 
     about 3-4% of one study's implantable pumps.
     On the other hand, if they were to significantly reduce the above 
     issues, I might be interested.  Having an almost instantaneous 
     response curve to insulin administration would take carb counting and 
     basal calculations to a new level.
     -David W.
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