Summary of findings 3. Analysis 4 ‐ Expanded polytetrafluoroethylene vs oxidised regenerated cellulose for adhesion prevention after gynaecological surgery.
| Expanded polytetrafluoroethylene vs oxidised regenerated cellulose (Interceed) for adhesion prevention after gynaecological surgery | ||||||
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Population: women having gynaecological surgery
Settings: surgical
Intervention: expanded polytetrafluoroethylene Comparison: oxidised regenerated cellulose | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | Number of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Oxidised regenerated cellulose | Expanded polytetrafluoroethylene | |||||
| Pelvic pain | Not reported in any study in this comparison | |||||
| Live birth rate | Not reported in any study in this comparison | |||||
| Adhesion score Non‐validated score out of 11 at SLL | Mean adhesion score was ‐3.79 lower (5.12 to 2.46 lower) in the expanded polytetrafluoroethylene group | 58 (1 study) | ⊕⊝⊝⊝ Very lowa,b,c | |||
| Incidence of adhesions ‐ de novo Incidence at second‐look laparoscopy | 149 per 1000 | 141 per 1000 (44 to 374) | OR 0.93 (0.26 to 3.41) | 38 (1 study) | ⊕⊝⊝⊝ Very lowc,d | |
| Incidence of adhesions ‐ re‐formation (or mixture) Incidence at second‐look laparoscopy | 567 per 1000 | 146 per 1000 (26 to 512) | OR 0.13 (0.02 to 0.8) | 23 (1 study) | ⊕⊝⊝⊝ Very lowc,d | Confidence interval crossed the line of no effect when a risk ratio rather than an odds ratio was calculated (RR 0.36, 95% CI 0.13 to 1.01) |
| Clinical pregnancy rate | Not reported in any study in this comparison | |||||
| *The basis for the assumed risk is the median oxidised regenerated cellulose group risk across studies. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; OR: odds ratio; RR: risk ratio. | ||||||
| GRADE Working Group grades of evidence. High quality: further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: we are very uncertain about the estimate. | ||||||
aDowngraded one level due to imprecision: small number of events and wide confidence intervals. bDowngraded one level due to risk of bias: non‐validated adhesion scoring system used. cDowngraded one level due to unclear risk of publication bias. dDowngraded two levels due to imprecision: small number of events and wide confidence intervals which cross the line of no effect.