Table 1.
Characteristics of included studies
| Study cohort | Study region | Study Design | Patients(I/C) | Sex(M/F) | Age (years) | Follow-up (months) | Location | Culture Results | Intervention | Local complications | Other Adverse Events | Outcomes | MINORS |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Humm, 2014 [31] | UK | Retrospective outcome study | 21/NA | 18/3 | 49 (28–88) | 16 (6–25) | 21 tibia | 4 Staphylococcus aureus, 4 Coagulase-negative Staphylococci, 4 Polymicrobial, 3 Negative, 6 Other organisms | Debridement, tobramycin-impregnated calcium sulfate | 7 aseptic wound leakage, 5 pin-tract infection | a transient acute kidney injury | Eradication rate, reoperation rate, delayed healing rate, rate of aseptic wound leakage | 8 |
| Andreacchio, 2019 [32] | France | Retrospective outcome study | 12/NA | 8/4 | 10.3 (2–15) | 24–72 | 3 tibia,4 femur, 2 humerus,1 clavicle,1radius,1 IV Metatarsal | 3 Methicillin-resistant Staphylococcus aureus, 7 Negative (other NS) | Debridement, tobramycin-impregnated calcium sulfate | None | None | Eradication rate, reoperation rate, refracture rate, rate of aseptic wound leakage | 9 |
| Ferguson, 2014 [33] | UK | Retrospective outcome study | 193(195 locations)/NA | 150/43 | 46.1 (16.1–82) | 44.44 (15.6–85.2) | 88 tibia, 73 femur, 10 humerus, 6 ankle, 5 radius, 4 knee fusion, 4 pelvis, 3 calcaneum, 1 ulna, 1 forefoot | 49 Methicillin-sensitive Staphylococcus aureus, 10 Coagulase-negative staphylococci, 7 Methicillin resistant Staphylococcus aureus, 4 Escherichia coli, 4 Enterobacter cloacae (other NS) | Debridement, tobramycin-impregnated calcium sulfate | 30 aseptic wound leakage, 9 collection of fluid and 9 refracture | 7 death (other reason) | Eradication rate, reoperation rate, refracture rate, delayed healing rate, rate of aseptic wound leakage | 13 |
| McKee, 2002 [15] | Canada | Prospective outcome study | 25/NA | 15/10 | 43 (27–69) | 28 (20–38) | 8 tibia, 6 femur, 3 ulna, 1 humerus | 9 Staphylococcus aureus, 4 Staphylococcus epidermidis, 4 Pseudomonas aeruginosa, 2 Enterobacter cloacae, other polymicrobial infections | Debridement, tobramycin-impregnated calcium sulfate | 8 aseptic wound leakage, 3 refracture, 2 persistent nonunion, 1 superficial wound necrosis, 1 hypertrophic nonunion | NR | Eradication rate, reoperation rate, refracture rate, delayed healing rate, rate of aseptic wound leakage | 9 |
| Gitelis, 2002 [34] | USA | Retrospective outcome study | 6/NA | 3/3 | 50 (26–85) | 28 (18–40) | 3 tibia, 3 femur | 5 Staphylococcus aureus, 1 Polymicrobial infections | Debridement, tobramycin-impregnated calcium sulfate | None | NR | Eradication rate, reoperation rate, refracture rate, delayed healing rate, rate of aseptic wound leakage | 8 |
| Qin, 2020 [30] | China | Retrospective outcome study | 33/NA | 26/7 | 44.5 (17–67) | 35.9 (12–75) | 33 calcaneum | 8 Staphylococcus aureus,6 Pseudomonas aeruginosa, 2 Enterococcus faecalis, 2 Proteus mirabilis,2 Enterobacter cloacae,10 negative (other NS) | Debridement, vancomycin and gentamicin-impregnated calcium sulfate | 13 aseptic wound leakage | 1 death (cardiovascular disease) | Eradication rate, reoperation rate, refracture rate, delayed healing rate, rate of aseptic wound leakage | 7 |
| Ferrando, 2017 [35] | Spain | Retrospective comparative study | 13/12 | 9/4 | 48 (17–67) | 22 (16–29) | 6 tibia, 4 calcaneum, 2 femur, 1 humerus | 5 methicillin-sensitive Staphylococcus aureus, 2 Methicillin-resistant S.aureus, 1 Pseudomonas aeruginosa, 1 Enterobacter cloacae, 1 Streptococcus agalactis,1 Escherichia coli,1 Polymicrobial infections | Debridement, vancomycin and gentamicin-impregnated calcium sulfate | 1 hematoma,1 mild seroma | None | Eradication rate, reoperation rate, delayed healing rate, rate of aseptic wound leakage | 15 |
| Badie, 2019 [36] | Egypt | Prospective outcome study | 30/NA | 25/5 | 26.2 (17–53) | > 12 | 14 tibia, 11 femur, 2 radius, 2 humerus, 1 ulna | 15 S. aureus, 3 methicillin resistant S. aureus, 2 Klebsiella Pneumoniae, 2 Escherichia coli, 2 Proteus mirabilis, 1 Salmonella, 1 Streptococcus, 2 polymicrobial infections, 2 negative | Debridement, vancomycin and gentamicin-impregnated calcium sulfate | 1 refracture | NR | Eradication rate, reoperation rate, refracture rate, delayed healing rate | 11 |
| Jiang, 2020 [23] | China | Retrospective outcome study | 34/NA | 27/7 | 41 (3–67) | 26 (12–68) | 34 calcaneum | 5 Pseudomonas aeruginosa, 2 Enterobacter cloacae, 2 Staphylococcus aureus (other NS) | Debridement, vancomycin and gentamicin-impregnated calcium sulfate | 11 aseptic wound leakage | 1 death (other reason) | Eradication rate, reoperation rate, refracture rate, delayed healing rate, rate of aseptic wound leakage | 9 |
| Zhou, 2020 [37] | China | Retrospective outcome study | 42(43 locations)/NA | 24/18 | 43.7 (23–74) | 42.8 (12.8–77.5) | 24 left tibia, 19 right tibia | 11 Staphylococcus aureus, 3 Pseudomonas aeruginosa, 1 Polymicrobial infections | Debridement, vancomycin and gentamicin-impregnated calcium sulfate | 13 paseptic wound leakage, 4 slight pain after a long-distance walk, 4 limb weakness or discomfort, 1 slight claudication | NR | Eradication rate, reoperation rate, refracture rate, delayed healing rate, rate of aseptic wound leakage | 8 |
| Qin, 2018 [29] | China | Retrospective comparative study | 35/NA | 26/9 | 38 (18–60) | 33.7 (25 ~ 41) | 35 tibia | 15 Staphylococcus aureus, 5 Escherichia Coli, 3 Pseudomonas Aeruginosa, 2 Serratia Marcescens, 2 Acinetobacter Baumannii, 2 Klebsiella Pneumoniae, other negative | Debridement, vancomycin and gentamicin-impregnated calcium sulfate | 8 pin-tract infection, 3 knee stiffness | None | Eradication rate, reoperation rate, delayed healing rate, rate of aseptic wound leakage | 7 |
| Gramlich, 2017 [38] | Gemany | Retrospective outcome study | 93/NA | 59/34 | 62 (11–84) | 11 (6–22) | 35 femur, 28 tibia, 7 fibula, 5 humerus, 5 hip joint, 4 Radius, 3 talus,, 3 pelvis (other NS) | 27 Staphylococcus aureus, 19 Staphylococcus epidermidis, 8 Pseudomonas aeruginosa, 5 Escherichia coli, 3 Klebsiella Pneumoniae (other NS) | Debridement, vancomycin and gentamicin-impregnated calcium sulfate | NR | NR | Eradication rate | 6 |
| Ruan, 2021 [39] | China | Retrospective outcome study | 35/NA | 25/10 | 54 (34–82) | 24–60 | 35 tibia | 4 Staphylococcus aureus, 2 Klebsiella Pneumoniae, 2 Streptococcus | Debridement, vancomycin and gentamicin-impregnated calcium sulfate | 5 anterolateral numbness of the iliac thigh, 2 relapse, 2 hematocele in the iliac bone area, 1 nonunion, 1 aseptic exudate | NR | Eradication rate, reoperation rate, refracture rate, delayed healing rate, rate of aseptic wound leakage | 10 |
| Gauland, 2011 [25] | USA | Retrospective outcome study | 323/NA | NR | NR | 60 | Lower-Extremity (NS) | NR | Debridement, vancomycin and gentamicin-impregnated calcium sulfate | NR | NR | Eradication rate, reoperation rate, delayed healing rate, rate of aseptic wound leakage | 8 |
| Sun, 2017 [40] | China | Retrospective outcome study | 12/NA | 7/5 | 54 (16–72) | 10.8 (6–18) | 12 jaw | 3 Staphylococcus aureus, 2 β-hemolytic streptococcu, 1 Escherichia coli, 1 Streptococcus viridans (other NS) | Debridement, vancomycin-impregnated calcium sulfate | 2 aseptic wound leakage | None | Eradication rate, reoperation rate, delayed healing rate, rate of aseptic wound leakage | 7 |
| Zhao, 2020 [41] | China | Retrospective comparative study | 10/21 | 10/0 | 48 (28.98–67.42) | 21.7 (15.8–27.6) | 5 femur, 5 tibia | 4 Staphylococcus aureus, 4 Negative (other NS) | Debridement, vancomycin-impregnated calcium sulfate | 3 aseptic wound leakage | None | Eradication rate, reoperation rate, delayed healing rate, rate of aseptic wound leakage | 14 |
NR, not reported; NS, not specified