Ultrasound study of heel to calcaneum depth in neonates

Aim-To investigate whether it would be safe to extend the currently recomme nded area of sampling to the whole heel in neonates. Methods-Eighty newborn infants were studied, weight range 0.56 to 4.34 kg, gestation 24 to 42 weeks. Ultrasound scanning was used to measure the short est distance between the skin and the perichondrium of the calcaneum. Results-The shortest depth of perichondrium was in the centre of the heel a nd ranged from 3 to 8 mm. In 78 of the 80 infants the distance was 4 mm or more. There was a small but significant positive correlation with weight. Conclusions-Standard automated lancets for preterm use that puncture to a d epth of 2.4 mm may be safely used anywhere over the plantar surface of the heel. The posterior aspect of the heel should be avoided. Reducing the dens ity of heel pricks should reduce the associated pain.