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Updated: Nov 19, 2025

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Inking of gross specimens: a systematic review
Suvarna Kizhakkoottu1, Gifrina Jayaraj1, Herald J Sherlin1
1Saveetha Dental College And Hospitals of the Saveetha Institute Of Medical And Technical Sciences of the Saveetha University, Chennai, India.
India ink remains the preferred surgical ink for marking tissue specimens due to its superior safety profile. While acrylic colors offer faster drying, India ink avoids tissue contamination and preserves cellular detail for accurate histopathological evaluation.
Area of Science:
- Surgical Pathology
- Histopathology
- Oncology
Background:
- Accurate histopathological evaluation of surgical margins is crucial for determining tumor spread and patient prognosis.
- Errors in margin identification can lead to treatment failure.
- Inking of resected specimens is a reliable method for margin identification.
Purpose of the Study:
- To systematically review studies comparing different materials used for inking surgically resected specimens.
- To evaluate the efficacy and safety of India ink, acrylic colors, and tissue marking dyes.
Main Methods:
- A systematic literature search was conducted using PubMed, Cochrane, and Google Scholar.
- Keywords included 'inking', 'tissue marking dyes', 'surgical margin', and 'grossing'.
- Three relevant articles with a total of 1325 samples were included in the review.
Main Results:
- Both India ink and acrylic colors demonstrated good ease of application and visibility.
- Acrylic colors had a shorter drying time than India ink.
- India ink showed advantages in not contaminating tissue processing fluids, interfering with cellular details, or penetrating tissues compared to acrylic colors.
Conclusions:
- India ink is currently the superior surgical ink, considering all evaluated parameters.
- Acrylic colors show potential as tissue marking dyes but have some disadvantages that require further investigation.
- Further studies are needed to fully assess acrylic colors and other emerging dyes.
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