Child Abuse Sexual Assault

Clinical Guide: Toluidine Blue Dye


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.

Factors that influence the variability in findings of anogenital injury in adolescent/adult sexual assault victims: a review of the forensic literature. (Laitinen, et al., 2013)

Reliability of female genital injury detection after sexual assault. (Sachs, et al., 2011)

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)

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)

(See also: NIJ’s Sexual Assault Medical Forensic Examination Research Forum: Examination Technology for current research questions about TB Dye)


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.

Atlas of Sexual Violence (Henry, pp. 100-101)

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)

Sexual Assault Across the Lifespan (Girardin, et al. starting on p. 661)

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


National Protocol for Sexual Assault Medical Forensic Examinations*

Search toluidine blue dye to find the various areas 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

{and some general commentary here…}


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