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 .
Choice of incision in surgical management of small bowel perforations in enteric fever.
Fifty six patients with typhoid enteric perforation who underwent operative treatment were r and omly assigned to 2 groups . Twenty seven patients in group A underwent laparotomy via the Rutherford-Morrison incision while 29 patients in group B underwent the same procedure via a right paramedian incision . Surgical treatment consisted of two layer closure of the perforation with peritoneal lavage and tube drainage in all cases . Mean operating time in group A and group B was 45 + /- 10 minutes and 73 + /- 6 minutes respectively ( p < 0.001 ) . Postoperative wound dehiscence in group A and group B was observed in 2 and 11 cases respectively ( p < 0.001 ) . Incisional hernia developed in 8 patients in group B and none in group A ( p < 0.01 ) . Two patients in group A and 10 in group B developed adhesion-obstruction ( p < 0.05 ) . Differences in wound sepsis , pelvic abscess and mortality were not significant . Mean hospital stay in groups A and B was 12.4 days and 16.8 days respectively ( p < 0.001 ) . We conclude that in the presence of a confirmed preoperative diagnosis of typhoid enteric perforation , laparotomy via the Rutherford-Morrison incision may significantly reduce postoperative wound complications and morbidity without significantly altering the overall outcome
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 .