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  1. Katsoulas, Theodoros PhD, MSc, RN
  2. Kapritsou, Maria PhD, MSc, RN
  3. Alexandrou, Evan PhD, MPH, RN, ICU Cert
  4. Bastaki, Maria PhD, MSc, RN
  5. Giannakopoulou, Margarita PhD, BSc, RN
  6. Kiekkas, Panagiotis PhD, MSc, RN
  7. Stafylarakis, Emmanouil MSc, BSc, RN
  8. Konstantinou, Evangelos A. PhD, MSc, BSN, RN


The use of peripheral implanted ports to administer parenteral nutrition in a number of patient cohorts is increasingly seen as a safe alternative to chest ports with equivalence in long-term outcomes. Two insertion sites on the upper arm were compared using the zone insertion method (ZIM), which was developed as an approach to optimize and reduce catheter-related exit site complications. The ZIM divides the medial upper arm into 3 main colors, red, green, and yellow, which are based on musculoskeletal, skin, and vessel characteristics. The optimal exit site is considered to be the green zone, the middle third of the upper arm. Thirty-five patients were allocated to vein puncture at the yellow/green zone (group A) and 35 patients at the yellow zone near the axilla (group B). All devices were implanted in the distal green zone. Successful peripheral port implantation was 91.4% (n = 35) for group A and 100.0% (n = 35) for group B (P = .07). No procedural or postprocedural complications were observed.