An automatic incision device for obtaining blood samples from the heels of preterm infants causes less damage than a conventional manual lancet

摘要

OBJECTIVES—To evaluatein a randomised blind study the effect on puncture site lesions of twodifferent incision devices used to obtain blood samples from preterminfants by repeated heel sticks. 
SETTING—The neonatalintensive care unit at the Hospital for Children and Adolescents andLaboratory, Helsinki University Central Hospital. 
PATIENTS—A total of100 preterm infants (birth weight below 2500 g) not previouslysubjected to heel stick sampling. 
INTERVENTIONS—Theinfants were randomly allocated to blood sampling from the heel witheither a conventional manual lancet or an automatic incision device.The same type of lancet was used for any given baby throughout thestudy (2-21 days).
MAIN OUTCOMEMEASURES—The damage caused by sampling wasevaluated using four criteria: bruising of the heel, inflammation ofthe heel, bruising of either the ankle or the leg, and skin healing atthe puncture site. The evaluation was based on photographs presentingtypical categories of each outcome. 
RESULTS—To obtain asufficient volume of blood, on average 2.6 times more punctures wereneeded when the conventional manual lancet was used than when theautomatic incision device was used. Heels punctured with the lancet hadmore bruising (100% v 84%) and more signsof inflammation (79% v 53%), and there wasmore bruising of the ankle or leg (92% v53%) than when the automatic incision device was used. Skin healedequally rapidly in the two groups.
CONCLUSION—The use ofan automatic incision device for collecting repeated skin puncturesamples from preterm infants is less traumatic than the use of aconventional manual lancet.