Raga 2009.

Methods	Single study centre. Patients were randomly allocated to either the control group (n = 25), or the intervention group (n = 25) according to a computer‐generated sequence. Informed consent was obtained in all cases according to the local ethics committee Power calculation: not done Loss of follow up: there was no loss to follow up and all patients were analysed in the group in which they were allocated
Participants	Setting: Tertiary University Teaching Hospital in Spain Inclusion criteria: symptomatic fibroids with uterine size greater or equal to 16 weeks gestation, and a request to retain their uterus Exclusion criteria: history of bleeding disorder, concurrent anticoagulant therapy, a haemoglobin level less than 10g/dl at the time of surgery, and pre‐malignant endometrial histologic findings Mean age: the mean age of patients was 32 years (range 24‐35 years) Ethnicity: not mentioned Myoma: mean number of fibroids per patient was 3.1 in the control and 3.2 in the intervention group. The mean uterine size was 17.9cm in the control group and 18.2cm in the intervention group
Interventions	Treatment group: gelatin‐thrombin matrix (Floseal Matrix, Baxter: a substance that activates the clotting process and stops bleeding) was delivered to the site of the uterine bleeding (wound) via a single‐barrel syringe and a special applicator tip according to the manufacturers instruction, before closure  Control group: isotonic sodium chloride solution was placed in the uterine bleeding site before closure Diluted vasopressin (1:60) was injected into the myometrium around the myoma and into the myoma tissue in both groups Type of operation: Laparotomy
Outcomes	Operative time, blood loss, intraoperative and postoperative complications, and duration of hospital stay
Notes	Authors not contacted
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Patients were randomly allocated according to a computer generated sequence
Allocation concealment (selection bias)	Unclear risk	Allocation concealment is not mentioned
Incomplete outcome data (attrition bias) All outcomes	Low risk	No incomplete outcome data
Selective reporting (reporting bias)	Unclear risk	We do not have access to the study protocol
Other bias	Low risk	No other sources of bias identified
Blinding of participants and personnel (performance bias) All outcomes	Low risk	Isotonic sodium chloride solution as placebo was placed in the uterine bleeding site before closure
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Information on blinding of outcome assessment not provided