Evaluation of a hydrogen peroxide-based system for high-level disinfection of vaginal ultrasound probes

J Ultrasound Med. 2013 Oct;32(10):1799-804. doi: 10.7863/ultra.32.10.1799.


Objectives: Because of the complex process and the risk of errors associated with the glutaraldehyde-based solutions previously used at our institution for disinfection, our department has implemented a new method for high-level disinfection of vaginal ultrasound probes: the hydrogen peroxide-based Trophon system (Nanosonics, Alexandria, New South Wales, Australia). The aim of this study was to compare the time difference, safety, and sonographers' satisfaction between the glutaraldehyde-based Cidex (CIVCO Medical Solutions, Kalona, IA) and the hydrogen peroxide-based Trophon disinfection systems.

Methods: The Institutional Review Board approved a 14-question survey administered to the 13 sonographers in our department. Survey questions addressed a variety of aspects of the disinfection processes with graded responses over a standardized 5-point scale. A process diagram was developed for each disinfection method with segmental timing analysis, and a cost analysis was performed.

Results: Nonvariegated analysis of the survey data with the Wilcoxon signed rank test showed a statistical difference in survey responses in favor of the hydrogen peroxide-based system over the glutaraldehyde-based system regarding efficiency (P = .0013), ease of use (P = .0013), ability to maintain work flow (P = .026), safety (P = .0026), fixing problems (P = .0158), time (P = .0011), and overall satisfaction (P = .0018). The glutaraldehyde-based system took 32 minutes versus 14 minutes for the hydrogen peroxide-based system; the hydrogen peroxide-based system saved on average 7.5 hours per week. The cost of the hydrogen peroxide-based system and weekly maintenance pays for itself if 1.5 more ultrasound examinations are performed each week.

Conclusions: The hydrogen peroxide-based disinfection system was proven to be more efficient and viewed to be easier and safer to use than the glutaraldehyde-based system. The adoption of the hydrogen peroxide-based system led to higher satisfaction among sonographers.

Keywords: infection control; transvaginal ultrasound; ultrasound technology.

Publication types

  • Comparative Study

MeSH terms

  • Disinfectants / economics
  • Disinfection / economics*
  • Disinfection / methods
  • Disinfection / statistics & numerical data
  • Equipment Design
  • Female
  • Glutaral / economics*
  • Health Care Costs / statistics & numerical data
  • Humans
  • Hydrogen Peroxide / economics*
  • Louisiana
  • Transducers / economics*
  • Ultrasonography / economics*
  • Ultrasonography / instrumentation*
  • Ultrasonography / statistics & numerical data
  • Vagina*


  • Disinfectants
  • Hydrogen Peroxide
  • Glutaral