Use of ultrasound jelly instead of normal saline during radiosurgery

PROBLEM

While doing radiosurgery, we have to apply normal saline to keep the skin tissue moist. Normal saline gets dried within 5 – 10 s, so we have to reapply it frequently if the radiosurgical procedure is long. If the lesions become dry, we are not able to cut or coagulate the lesion. This also requires the help of an assistant to constantly keep the lesion moist so as to perform the radiosurgical procedure.

SOLUTION

Ultrasound jelly is a good option to use instead of normal saline. Once applied, it keeps the skin tissue moist for almost 5 min. It is cheap, easily available, and mitigates the need for assistance during the procedure. Electrocardiogram jelly is another alternative.

Ultrasound jelly constitutes Carbopol 934, propylene glycol, methylparaben, triethanolamine, and blue dye 0.1%.^[1] Adverse skin reactions with Doppler ultrasound gel are rare and related mostly to allergic contact dermatitis or contact urticaria [Video 1]. So far, 14 cases of contact dermatitis linked to ultrasonic gel have been reported in the published work.^[2] The allergens involved are propylene glycol, imidazolidinyl urea, phenoxyethanol, triethanolamine, ethyl, methyl, butyl, and propyl parabens.