Streptokinase versus alteplase and other treatments for acute and delayed thrombolysis of blood stains in clothing.

OBJECTIVE To assess the usefulness of heparin, alteplase, and streptokinase in removing blood stains. DESIGN Randomised controlled trial. SETTING Hospital laundry. INTERVENTIONS Blood stains were allocated to treatment with alteplase, streptokinase, heparin, a commercial enzymatic stain remover, or no treatment at all after three or seven hours and then washed in hot or cold water two hours later. RESULTS Both hot water and early treatment were strongly associated with improved stain removal. All four treatments were associated with a worse outcome than no treatment at all, although for streptokinase this trend did not reach significance. The commercial stain remover gave the worst results of all treatments tested. CONCLUSIONS Contrary to popular wisdom, hot water is much more effective than cold in removing blood stains. Methodologically rigorous research and evidence based principles are needed within the laundry industry, and the role of thrombolytic drugs should be assessed further.