Abstract
To determine the incidence of toluidine blue positive findings after speculum examination
of sexual assault victims, we performed a prospective before and after study of 27
female patients presenting after sexual assault to a free-standing nurse examiner
clinic. Before the insertion of a speculum, a 1% aqueous solution of toluidine blue
was applied to the posterior fourchette and photographs were taken using colposcopy
with digital imaging (16 × magnification). After the forensic examination was completed,
dye was reapplied. Photographs taken before and after speculum examination were reviewed
by three EM physicians for superficial lacerations or abrasions. Before speculum examination,
genital injuries from sexual assault were documented in 67% of the patients (mean
number of genital injuries, 1.4). After speculum examination, one patient (3.7%) demonstrated
a new genital injury—an abrasion to the labia. Until further studies are performed,
use of a speculum should be delayed until after toluidine dye application.
Keywords
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References
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Article Info
Publication History
Accepted:
April 23,
2003
Received:
February 23,
2003
Identification
Copyright
© 2004 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
