None of the techniques that were compared significantly reduced the incidence of adhesive small bowel obstruction .
None of the specific techniques that were compared reduced the two main adhesion-related clinical outcomes , small bowel obstruction and infertility .
The meta- analysis provides little evidence for the surgical principle that using less invasive techniques , introducing less foreign bodies or causing less ischaemia reduces the extent and severity of adhesions
INTRODUCTION Adhesion formation is the most common complication following  peritoneal surgery  and the leading cause of small bowel obstruction , acquired infertility and inadvertent organ injury at reoperation .
Using a ' good surgical technique ' is advocated as a first step in preventing adhesions .
However , the evidence for different surgical techniques to reduce adhesion formation needs confirmation .
Effect of closure versus nonclosure of peritoneum at cesarean section on adhesions: a prospective randomized study.
OBJECTIVE We sought to determine the effect of nonclosure of the visceral and parietal peritoneum during cesarean section on the formation of adhesions . STUDY DESIGN This was a prospect i ve r and omized trial of 533 women undergoing primary cesarean section ; in 256 the peritoneum was left open and in 277 it was closed . Fifty women in the nonclosure group and 47 women in the closure group were subsequently evaluated intraoperatively at a repeat cesarean . The presence of adhesions and their severity were evaluated at several sites . RESULTS The nonclosure and closure groups were comparable with regard to the proportion of patients with adhesions at any site ( 60 % vs 51 % , respectively ; P = .31 ) . Time from incision to delivery was comparable in the nonclosure and closure groups ( 8.98 ± 4.7 vs 9.32 ± 5.2 minutes , respectively ; P = .84 ) . CONCLUSION Closure or nonclosure of the peritoneum at cesarean section did not lead to large differences in the adhesion rate
None of the techniques that were compared significantly reduced the incidence of adhesive small bowel obstruction .
None of the specific techniques that were compared reduced the two main adhesion-related clinical outcomes , small bowel obstruction and infertility .
The meta- analysis provides little evidence for the surgical principle that using less invasive techniques , introducing less foreign bodies or causing less ischaemia reduces the extent and severity of adhesions
INTRODUCTION Adhesion formation is the most common complication following  peritoneal surgery  and the leading cause of small bowel obstruction , acquired infertility and inadvertent organ injury at reoperation .
Using a ' good surgical technique ' is advocated as a first step in preventing adhesions .
However , the evidence for different surgical techniques to reduce adhesion formation needs confirmation .