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Clinical Guide: Toluidine Blue Dye

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Over the last couple weeks I’ve received several questions related to using Toluidine Blue dye in sexual assault medical-forensic exams, so I figured it was time to put together a clinical guide on the topic.


There’s been very little written about TB dye in the peer reviewed literature over the past 30 years, so I have included all of it (that I could find) here. Some discuss the utility of TB dye in greater depth than others. As with any research, it is imperative that you read these articles (particularly the older ones) with a critical eye toward the methodology used and the relevance of their findings in light of advances in the science. All links go to PubMed abstracts.

Comparison of methods for identifying ano-genital injury after consensual intercourse. (Zink, et al., 2009)

Validation set correlates of anogenital injury after sexual assault. (Drocton, et al. 2008)

Significance of toluidine blue positive findings after speculum examination for sexual assault. (Jones, et al., 2004)

Signs of genital trauma in adolescent rape victims examined acutely. (Adams, et al., 2000)

Patterns of genital injury in female sexual assault victims. (Slaughter, et al., 1997)

Effects of toluidine blue and destaining reagents used in sexual assault examinations on the ability to obtain DNA profiles from postcoital vaginal swabs. (Hochmeister, et al., 1997)

Medical assessment of children who have been recently raped. (Kaufhold, 1993. No abstract available; full citation: Journal of Child Sexual Abuse, Volume 2, Issue 1, 1993, Pages 105 – 112)

Toluidine blue in the detection at autopsy of perineal and perianal victims of sexual abuse. (Bays & Lewman, 1992)

Toluidine blue in the detection of perineal lacerations in pediatric and adolescent sexual abuse victims. (McCauley, et al., 1986)

Use of toluidine blue for documentation of traumatic intercourse. (Lauber & Souma, 1982)


Some of the textbooks make mention of TB dye and its application. I’ve included links to them via Google Books. Just like with the research articles, read with a critical eye–I’m not endorsing any particular textbook, just giving you the particulars of where to find the information.

Forensic Emergency Medicine (2nd Ed.). (Olshaker, et al. pp. 99-101)

Obstetric & Gynecologic Emergencies. (Pearlman, et al., p. 478)

Forensic Nursing. (Pyrek, p. 164)

Clinical Forensic Medicine. (Stark, pp. 92-93).

Manual of Forensic & Emergency Medicine. (Riviello, pp. 115-116)

Color Atlas of Sexual Assault (Girardin, et al., pp. 102, 120-121: no page views in Google Books)

Sexual Assault Across the Lifespan (Girardin, et al. starting on p. 661: no page views in Google Books)

Sexual Assault (Crowley, pp. 85-86: no page views in Google Books)

Web Publications (full-text)

Forensic Times, Vol. 1 Issue 3 (Academy of Forensic Nursing Science, pp. 7-8)

National Protocol for Sexual Assault Medical Forensic Examinations*

Toluidine Blue Dye query (all sections of the National Protocol where TB dye is mentioned)

*many state and local protocols address TB dye use, but those are too numerous to include here

To Purchase:

Single dose applicators (25 or 50/box): National Forensic Nursing Institute

500ml or 1L: Newcomer Supply (no minimum order)


Written by Jenifer

June 24, 2009 at 6:43 am

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