An automatic incision device for obtaining blood samples from the heels of preterm infants causes less damage than a conventional manual lancet
H Vertanena, V Fellmanb, M Brommelsc, L Viinikkaa
a Department of
Clinical Chemistry, Helsinki University Central Hospital, Helsinki,
Finland, b Hospital for Children and Adolescents, Helsinki
University Central Hospital, c Department of Public Health, University of
Helsinki, Helsinki
Correspondence to: Ms Vertanen, Department of Clinical Chemistry, Hospital for Children and Adolescents, PO Box 281, FIN-00029 HUS, Finland email: helena.vertanen{at}hus.fi
Accepted 8 April 2000
OBJECTIVES
To evaluate
in a randomised blind study the effect on puncture site lesions of two
different incision devices used to obtain blood samples from preterm
infants by repeated heel sticks.
SETTINGThe neonatal
intensive care unit at the Hospital for Children and Adolescents and
Laboratory, Helsinki University Central Hospital.
PATIENTSA total of
100 preterm infants (birth weight below 2500 g) not previously
subjected to heel stick sampling.
INTERVENTIONSThe
infants were randomly allocated to blood sampling from the heel with
either a conventional manual lancet or an automatic incision device.
The same type of lancet was used for any given baby throughout the
study (2-21 days).
MAIN OUTCOME
MEASURESThe damage caused by sampling was
evaluated using four criteria: bruising of the heel, inflammation of
the heel, bruising of either the ankle or the leg, and skin healing at
the puncture site. The evaluation was based on photographs presenting
typical categories of each outcome.
RESULTSTo obtain a
sufficient volume of blood, on average 2.6 times more punctures were
needed when the conventional manual lancet was used than when the
automatic incision device was used. Heels punctured with the lancet had
more bruising (100% v 84%) and more signs
of inflammation (79% v 53%), and there was
more bruising of the ankle or leg (92% v
53%) than when the automatic incision device was used. Skin healed
equally rapidly in the two groups.
CONCLUSIONThe use of
an automatic incision device for collecting repeated skin puncture
samples from preterm infants is less traumatic than the use of a
conventional manual lancet.
Keywords: newborn; blood sampling; skin puncture; puncture site healing; heel
© 2001 by Archives of Disease in Childhood
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