Chlorhexidine Gluconate as a Conducting Medium Is Noninferior to Ultrasound Gel in Ultrasound Image Quality: A Blinded, Randomized Comparative Study.

BACKGROUND

Ultrasound imaging is increasingly used by physicians for both diagnostic and image-guided procedures. A coupling medium is used to facilitate transmission of ultrasound waves from the transducer to tissues by eliminating air interference. The ideal coupling medium would be inexpensive, provide effective transmission, and neither introduce infection nor damage the skin or transducer. Ultrasound gel, a commonly used coupling medium, has the potential to transmit infection. This blinded, randomized study assessed the noninferiority of ultrasound image quality using chlorhexidine gluconate with isopropyl alcohol as coupling medium compared with ultrasound gel.

METHODS

Sixty different locations were imaged on 2 healthy volunteers. The order of use of the 2 coupling media was randomized at each location without changing the imaging site or ultrasound settings. The images were then coded to facilitate blinding. Two blinded reviewers evaluated the coded images using a comparative rating scale.

RESULTS

Chlorhexidine gluconate demonstrated a slightly improved image quality (mean 2.53; 95% CI, 2.46-2.60) compared with ultrasound gel (mean, 2.42; 95% CI, 2.35-2.50) (P = .04).

CONCLUSIONS

The commonly used skin antiseptic chlorhexidine gluconate with isopropyl alcohol demonstrated noninferior image quality compared with ultrasound gel and may represent a more economical alternative for ultrasound-guided interventions, with the potential to reduce infectious complications.