Jansen 1988.

Study characteristics
Methods	Truly randomised trial (random numbers generated) Time of randomisation: not stated Power calculation done Location: Sydney, Australia Timing and duration: Nov 1983 to Oct 1984
Participants	Infertile women undergoing open gynaecological microsurgery Condition: pelvic adhesions; endometriosis; tubal disease; uterine abnormalities Surgery performed: adhesiolysis or treatment for endometriosis (52); tubal anastomosis or uterine surgery (40) Pre‐existing adhesions: 63 women Mean age: 28 years (range 21 to 42) Duration infertility: not stated Infertility work‐up: not stated Number eligible: 102 Number undergoing second‐look laparoscopy: 92 Timing second‐look laparoscopy: 12 days postoperative Blinding at second‐look laparoscopy: yes
Interventions	Heparin containing Ringer's lactate versus Ringer's lactate Route of administration: intraperitoneal preoperative pelvic irrigation Dosage/volume: Ringer's solution containing 5000 IU heparin/L Other adjuvants: 52 women with pre‐existing adhesions or endometriosis received systemic steroids intraoperatively and postoperatively. The first 46 women in the study received intraperitoneal steroids Prophylactic antibiotics: yes
Outcomes	Analysed in review Adhesions at second‐look laparoscopy Improvement; no change; deterioration Change in score Other outcomes Blood transfusion requirements Wound healing
Notes	Adhesion scoring system used Modified American Fertility Society endometriosis scoring system (range 0 to 27) Data for adhesions at SLL (improvement; no change; deterioration) derived from scatter plot Some study information supplied in correspondence from study authors
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Quote: "Strictly in a pre‐determined random sequence"
Allocation concealment (selection bias)	Unclear risk	Insufficient information available to permit judgement
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	Quote: "Although completely effective blinding in heparin use was not practicable, owing to its obvious anticoagulant effect during the operation, information on its allocation was not recorded in the operation notes and was not available at the time of postoperative laparoscopy". Initial surgeons not completely blinded to allocation and unclear whether women were blinded.
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Quote: "Improvement scores were derived later, without knowledge of the identity of the patient, or the use of heparin"
Incomplete outcome data (attrition bias) All outcomes	Low risk	No missing outcome data
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	Unclear risk	The practice of adding hydrocortisone sodium succinate to the irrigation solution was stopped after 46 women had received it, because of a possible detrimental effect reported in an earlier study