{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T17:14:31Z","timestamp":1783358071671,"version":"3.54.6"},"reference-count":23,"publisher":"BMJ","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Dis Child Fetal Neonatal Ed"],"accepted":{"date-parts":[[2000,4,8]]},"published-print":{"date-parts":[[2001,1,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>SETTING<\/jats:title>\n                  <jats:p>The neonatal intensive care unit at the Hospital for Children and Adolescents and Laboratory, Helsinki University Central Hospital.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>PATIENTS<\/jats:title>\n                  <jats:p>A total of 100 preterm infants (birth weight below 2500 g) not previously subjected to heel stick sampling.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>INTERVENTIONS<\/jats:title>\n                  <jats:p>The 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\u201321 days).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>MAIN OUTCOME MEASURES<\/jats:title>\n                  <jats:p>The 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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>To 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% <jats:italic>v<\/jats:italic> 84%) and more signs of inflammation (79% <jats:italic>v<\/jats:italic> 53%), and there was more bruising of the ankle or leg (92% <jats:italic>v<\/jats:italic>53%) than when the automatic incision device was used. Skin healed equally rapidly in the two groups.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSION<\/jats:title>\n                  <jats:p>The 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.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/fn.84.1.f53","type":"journal-article","created":{"date-parts":[[2002,7,27]],"date-time":"2002-07-27T06:40:22Z","timestamp":1027752022000},"page":"F53-F55","source":"Crossref","is-referenced-by-count":31,"title":["An automatic incision device for obtaining blood samples from the heels of preterm infants causes less damage than a conventional manual lancet"],"prefix":"10.1136","volume":"84","author":[{"given":"H","family":"Vertanen","sequence":"first","affiliation":[{"name":"aDepartment of Clinical Chemistry, Helsinki University Central Hospital, Helsinki, Finland, \n\nbHospital for Children and Adolescents, Helsinki University Central Hospital, \n\ncDepartment of Public Health, University of Helsinki, Helsinki"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V","family":"Fellman","sequence":"additional","affiliation":[{"name":"aDepartment of Clinical Chemistry, Helsinki University Central Hospital, Helsinki, Finland, \n\nbHospital for Children and Adolescents, Helsinki University Central Hospital, \n\ncDepartment of Public Health, University of Helsinki, Helsinki"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Brommels","sequence":"additional","affiliation":[{"name":"aDepartment of Clinical Chemistry, Helsinki University Central Hospital, Helsinki, Finland, \n\nbHospital for Children and Adolescents, Helsinki University Central Hospital, \n\ncDepartment of Public Health, University of Helsinki, Helsinki"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L","family":"Viinikka","sequence":"additional","affiliation":[{"name":"aDepartment of Clinical Chemistry, Helsinki University Central Hospital, Helsinki, Finland, \n\nbHospital for Children and Adolescents, Helsinki University Central Hospital, \n\ncDepartment of Public Health, University of Helsinki, Helsinki"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2001,1,1]]},"reference":[{"key":"2025090512495967000_84.1.F53.1","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1093\/clinchem\/27.5.759","article-title":"Volume of blood removed for analytical purposes during hospitalization of low-birthweight infants.","volume":"27","author":"Nex\u00f8","year":"1981","journal-title":"Clin Chem"},{"key":"2025090512495967000_84.1.F53.2","first-page":"399","article-title":"Blood sampling in very low birth weight infants receiving different levels of intensive care.","volume":"147","author":"Obladen","year":"1988","journal-title":"Pediatrics"},{"key":"2025090512495967000_84.1.F53.3","doi-asserted-by":"crossref","first-page":"1669","DOI":"10.1093\/clinchem\/31.10.1669","article-title":"Studies on the quality of specimens obtained by skin-puncture of children. 2. An analysis of blood-collecting practices in a pediatric hospital.","volume":"31","author":"Meites","year":"1985","journal-title":"Clin Chem"},{"key":"2025090512495967000_84.1.F53.4","doi-asserted-by":"crossref","first-page":"1890","DOI":"10.1093\/clinchem\/34.9.1885","article-title":"Skin-puncture and blood-collecting technique for infants: update and problems.","volume":"34","author":"Meites","year":"1988","journal-title":"Clin Chem"},{"key":"2025090512495967000_84.1.F53.5","doi-asserted-by":"publisher","DOI":"10.1542\/peds.101.2.194"},{"key":"2025090512495967000_84.1.F53.6","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(84)90813-3"},{"key":"2025090512495967000_84.1.F53.7","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(93)90116-7"},{"key":"2025090512495967000_84.1.F53.8","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(94)00213-X"},{"key":"2025090512495967000_84.1.F53.9","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1542\/peds.98.5.925","article-title":"Experience in a neonatal intensive care unit affects pain response.","volume":"98","author":"Johnston","year":"1996","journal-title":"Pediatrics"},{"key":"2025090512495967000_84.1.F53.10","doi-asserted-by":"publisher","DOI":"10.1080\/080352598750013879"},{"key":"2025090512495967000_84.1.F53.11","doi-asserted-by":"publisher","DOI":"10.1542\/peds.101.5.882"},{"key":"2025090512495967000_84.1.F53.12","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(76)80272-7"},{"key":"2025090512495967000_84.1.F53.13","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1016\/S0140-6736(79)90765-7","article-title":"Recommended site and depth of newborn heel skin puncture based on anatomical measurements and histopathology.","volume":"i","author":"Blumenfeld","year":"1979","journal-title":"Lancet"},{"key":"2025090512495967000_84.1.F53.14","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(80)80702-5"},{"key":"2025090512495967000_84.1.F53.15","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1093\/clinchem\/36.3.547","article-title":"Optimal sites and dephts for skin puncture of infants and children as assessed from anatomical measurements.","volume":"36","author":"Reiner","year":"1990","journal-title":"Clin Chem"},{"key":"2025090512495967000_84.1.F53.16","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1093\/labmed\/20.7.481","article-title":"Development and evaluation of a new instrument for safe heelstick sampling of neonates.","volume":"20","author":"Burns","year":"1989","journal-title":"Lab Med"},{"key":"2025090512495967000_84.1.F53.17","first-page":"18","article-title":"Comparative studies of bruising and healing after heelstick.","volume":"Sep\/Oct","author":"Blain-Lewis","year":"1992","journal-title":"Neonatal Intensive Care"},{"key":"2025090512495967000_84.1.F53.18","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.1993.02160270108032"},{"key":"2025090512495967000_84.1.F53.19","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1080\/00365518709168891","article-title":"Recommendation for collection of skin puncture blood from children, with special reference to production of reference values.","volume":"47","author":"Alstr\u00f6m","year":"1987","journal-title":"Scand J Clin Lab Invest"},{"key":"2025090512495967000_84.1.F53.20","doi-asserted-by":"crossref","first-page":"908","DOI":"10.1093\/clinchem\/38.6.908","article-title":"A study of experimental lancets for blood collection to avoid bone infection of infants.","volume":"38","author":"Meites","year":"1992","journal-title":"Clin Chem"},{"key":"2025090512495967000_84.1.F53.21","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.1973.04160010073017"},{"key":"2025090512495967000_84.1.F53.22","doi-asserted-by":"crossref","first-page":"302","DOI":"10.2106\/00004623-198668020-00019","article-title":"Growth disturbance of the hind part of the foot following osteomyelitis of the calcaneus in the newborn.","volume":"68","author":"Borris","year":"1986","journal-title":"J Bone Joint Surg [Am]"},{"key":"2025090512495967000_84.1.F53.23","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1093\/clinchem\/27.6.875","article-title":"Studies on the quality of specimens obtained by skin puncture of children. 1. Tendency to hemolysis, and hemoglobin and tissue fluid as contaminants.","volume":"27","author":"Meites","year":"1981","journal-title":"Clin Chem"}],"container-title":["Archives of Disease in Childhood - Fetal and Neonatal Edition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/fn.84.1.F53","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T19:50:10Z","timestamp":1757101810000},"score":1,"resource":{"primary":{"URL":"https:\/\/fn.bmj.com\/lookup\/doi\/10.1136\/fn.84.1.F53"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2001,1,1]]},"references-count":23,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2001,1,1]]},"published-print":{"date-parts":[[2001,1,1]]}},"alternative-id":["10.1136\/fn.84.1.F53"],"URL":"https:\/\/doi.org\/10.1136\/fn.84.1.f53","relation":{},"ISSN":["1359-2998","1468-2052"],"issn-type":[{"value":"1359-2998","type":"print"},{"value":"1468-2052","type":"electronic"}],"subject":[],"published":{"date-parts":[[2001,1,1]]}}}