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

Objectives-To evaluate in a randomised blind study the effect on puncture s ite lesions of two different incision devices used to obtain blood samples from preterm infants by repeated heel sticks. Setting-The neonatal intensive care unit at the Hospital for Children and A dolescents and Laboratory, Helsinki University Central Hospital. Patients-A total of 100 preterm infants (birth weight below 2500 g) not pre viously subjected to heel stick sampling. Interventions-The infants were randomly allocated to blood sampling from th e heel with either a conventional manual lancet or an automatic incision de vice. The same type of lancet was used for any given baby throughout the st udy (2-21 days). Main outcome measures-The damage caused by sampling was evaluated using fou r criteria: bruising of the heel, inflammation of the heel, bruising of eit her the ankle or the leg, and skin healing at the puncture site. The evalua tion was based on photographs presenting typical categories of each outcome . Results-To obtain a sufficient volume of blood, on average 2.6 times more p unctures were needed when the conventional manual lancet was used than when the automatic incision device was used. Heels punctured with the lancet ha d more bruising (100% v 84%) and more signs of inflammation (79% v 53%), an d there was more bruising of the ankle or leg (92% v 53%) than when the aut omatic incision device was used. Skin healed equally rapidly in the two gro ups. Conclusion-The use of an automatic incision device for collecting repeated skin puncture samples from preterm infants is less traumatic than the use o f a conventional manual lancet.