Buttram 1983.

Study characteristics
Methods	Truly randomised trial (method not stated) Time of randomisation: not stated Double‐blind Location: multi‐centre—9 centres in the USA (Duke, Yale, Baylor, USC, Vanderbilt, Washington, Indiana, Navy, and Masachussets) Timing and duration: not stated
Participants	Infertile women undergoing open gynaecological surgery (macrosurgery 53, loupe magnification 32, microsurgery 17) Condition: pelvic inflammatory disease with distal tubal disease (42), endometriosis (14), pelvic adhesions (46) Surgery performed: adhesiolysis, tubal surgery Pre‐existing adhesions: all women Age: 18 to 35 years (mean not stated) Duration infertility: not stated Infertility work‐up: semen analysis, postcoital test, and confirmation of ovulation (method not stated). Any abnormality was corrected before surgery Number randomly assigned: ? (no exclusions stated) Number undergoing treatment: 102 Number undergoing second‐look laparoscopy: 91 (11 conceived before laparoscopy) Timing second‐look laparoscopy: 8 to 12 weeks postoperative Blinding at second‐look laparoscopy: not explicitly stated Females 18 years of age and older undergoing laparotomy for gynaecological surgery Exclusion criteria: pregnancy, cancer, PID Number of women randomly assigned: 102
Interventions	Dextran versus normal saline Route of administration: intraperitoneal Dosage/volume: dextran 250 mL; saline 250 mL Prophylactic antibiotics: yes
Outcomes	Analysed in review Pregnancy rate Method of diagnosis: not stated Duration follow‐up: 8 to 12 weeks Adhesions at second‐look laparoscopy Improvement Change in score Other outcomes` Adhesions at second‐look laparoscopy Present, absent; according to anatomical site Appearance of tube Tubal patency rate Postoperative infection rate
Notes	Adhesion scoring system used Hulka system based on extent of adhesions (scored from 1 to 4) over fimbriae and ovaries (range 0 to 16) 1 = whole organ seen 2 = > 50% seen 3 = < 50% seen 4 = totally obscured
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Insufficient information to permit judgement. "Patients were randomly assigned to either treatment"
Allocation concealment (selection bias)	Unclear risk	Insufficient information to permit judgement.
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	Insufficient information to permit judgement. "Blinded"
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Insufficient information to permit judgement. "Blinded"
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Exclusion criteria for randomisation; number of women randomly assigned not stated. All women who underwent treatment were accounted for.
Selective reporting (reporting bias)	Unclear risk	Data presented in full for all outcomes specified, however, no study protocol or trial registry identified for comparison
Other bias	Low risk	No others