Trew 2011.

Study characteristics
Methods	Truly randomised trial (telephone‐generated) Time of randomisation: 24 hours before surgery Double‐blind. Independent blinded video reviewer Power calculation: yes ITT: yes Location: multi‐centre—25 centres in Europe Timing and duration: Sep 2003 to Aug 2005; 1 year 11 months
Participants	Females, 18 years of age and older, undergoing laparoscopic gynaecological surgery only Indication for surgery: myoma or endometriotic cysts Number randomly assigned: 498 Number undergoing second‐look laparoscopy: 330 Timing second‐look laparoscopy: 4 to 16 weeks postoperative Blinding at SLL: yes Exclusion criteria: endometriosis stage 3 to 4, AFS score moderate or severe, pregnancy, systemic corticosteroids, antineoplastic drugs or radiation, GnRHa, active pelvic or abdominal infection, known allergy to starch polymer, prior surgery for endometriotic cysts, > 4 myomas, largest myoma < 2 or > 8 cm in diameter, cancer, re‐formed adhesions not counted, drain, pedunculated cysts, use of glue or other anti‐adhesion agent
Interventions	Icodextrin 4% versus Ringer's lactate > 100 mL every 30 minutes, no limit on amount used for irrigation. 1000 mL instilled at end
Outcomes	Analysed in review Adhesions at second‐look laparoscopy Mean adhesion score Other outcomes Adhesions at second‐look laparoscopy Number of adhesions 1 or more de novo adhesions at SLL Number of de novo adhesions at SLL Mean AFS score reduction Number of women free of de novo adhesions Many subgroup analyses based on sites of adhesions
Notes	mAFS score. Looked only at de novo adhesions, not re‐formed Funded by Innovata Ltd, Vectura Group
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Quote: "Treatment was randomised through a 24‐h central randomization telephone system"
Allocation concealment (selection bias)	Low risk	Quote: "Double‐blinding was possible as both fluids are clear and odourless solutions with similar viscosities and were packaged identically"
Blinding of participants and personnel (performance bias) All outcomes	Low risk	Both women and initial operating surgeons blinded to allocation
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Quote: "The surgery was video recorded according to a detailed protocol to enable all assessments to be made through an independent and blinded review of video recordings...reviewers were blinded to the study treatment assignment, subject confidential information, and investigator site identifiers...first and second procedures were scored independently"
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	Low risk	Funded by Innovata Ltd, Vectura Group