Toluidine Blue...

It's going to stain for a bit. We use surgilube as well. Does the vinegar spray work any better?

Because you are looking for dye uptake in small abrasions that you might not otherwise see. Sometimes you do have to paint an area, then remove excess. Depends on how your toluidine blue comes packaged, too — some places have sponge-tip applicators, and other places might have a bottle of toluidine blue that you pour into a medicine cup and apply with a cotton ball.

Interesting! That is how I originally thought the dye would be used... although, in my mentorship program it was drilled into me that we "never" paint... only highlight what is already evident to make it stand out in photos. Do you by chance have any literature backing this procedure up that I could present to those telling me not to do it that way?

Not offhand; I am just going by what we did in our SANE program per our protocol. The whole point of toluidine blue is that it is a stain, which means it is applied and then excess removed (we used Surgilube as I mentioned). It's not so much meant to highlight what is apparent with the naked eye, but to reveal things that are not so obvious, knowing that any areas of uptake indicate damage/injury. That is why you always need to use the toluidine blue before a speculum exam — because the exam itself can cause micro trauma. Using toluidine blue correctly has been shown to increase the detection of trauma by a large percentage — I think 20-30% or thereabouts? — particularly in the posterior fourchette area. I am sure you can find this info via Google, this is just what I remember from my years as a SANE.