Eficacia, bioseguridad y costo-efectividad de los antisépticos descritos en dermatología mínimamente invasiva: Revisión sistemática
DOI:
https://doi.org/10.33448/rsd-v15i4.50892Palabras clave:
Dermatología, Antiinfecciosos Locales, Análisis de Costo-Efectividad.Resumen
La preparación del lecho de la herida y el control de la carga microbiana dependen del uso de antisépticos tópicos, lo que requiere un equilibrio entre eficacia, bioseguridad y viabilidad económica. El objetivo de esta revisión sistemática es analizar la eficacia, bioseguridad y coste-efectividad de los antisépticos tópicos y los nuevos agentes antimicrobianos en dermatología mínimamente invasiva. La revisión siguió las directrices PRISMA y se registró en PROSPERO. Se realizó una búsqueda en la base de datos PubMed de ensayos clínicos aleatorizados, evaluando el riesgo de sesgo mediante la herramienta Cochrane RoB 2.0. Una búsqueda complementaria abarcó la literatura gris para obtener datos económicos. Las formulaciones avanzadas, como la polihexametilen biguanida (PHMB) y las nanopartículas de plata (AgNP), demostraron superioridad clínica y alta tolerabilidad celular para acelerar la cicatrización de heridas complejas en comparación con las terapias tradicionales. El peróxido de hidrógeno al 40% demostró ser altamente eficaz y seguro para la eliminación no invasiva de las queratosis seborreicas. En el análisis farmacoeconómico, los apósitos de plata modernos y la PHMB generaron ahorros generales al reducir las complicaciones, las estancias hospitalarias y los cambios de apósito, compensando así el coste de adquisición. Los antifúngicos de primera línea mantuvieron una alta rentabilidad. Se concluye que los agentes antisépticos innovadores ofrecen una eficacia y bioseguridad superiores a los antisépticos clásicos en dermatología. Su adopción resulta rentable, optimizando el tiempo de tratamiento y mejorando la calidad de vida del paciente.
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