HEMANGIOMA INFANTIL DE ALTO RIESGO: TRATAMIENTO ESCALONADO CON PROPRANOLOL, LÁSER Y CIRUGÍA RECONSTRUCTIVA - QUIÉN SE BENEFICIA, CUÁNDO INTERVENIR Y CÓMO MEDIR RESULTADOS
Palabras clave:
Hemangioma. Propranolol. Terapia por Láser. Procedimientos Quirúrgicos Reconstructivos. Resultado del TratamientoResumen
DOI: https://doi.org/10.46296/yc.v10i18.0879
Resumen
Se realizó una revisión crítica narrativa sobre el tratamiento escalonado del hemangioma infantil de alto riesgo con propranolol, láser y cirugía reconstructiva, con el fin de establecer quiénes se benefician, cuándo intervenir y cómo medir resultados. Se efectuó una búsqueda estructurada en PubMed/MEDLINE de literatura publicada entre 2016 y febrero de 2026 y se seleccionaron 50 referencias verificables. La evidencia mostró que la remisión temprana, idealmente antes del primer mes de vida, es decisiva porque el crecimiento más acelerado ocurre en los primeros meses. El propranolol oral se mantuvo como tratamiento de primera línea; el láser fue útil como coadyuvante para componente superficial, ulceración y telangiectasias residuales; y la cirugía reconstructiva siguió indicada para deformidad residual, tejido fibroadiposo, cicatriz o lesiones seleccionadas refractarias. Los resultados deben valorarse con desenlaces compuestos que integren control tumoral, rescate funcional, cicatrización, seguridad, rebrote, secuelas estéticas y carga familiar.
Palabras claves: Hemangioma. Propranolol. Terapia por Láser. Procedimientos Quirúrgicos Reconstructivos. Resultado del Tratamiento.
Abstract
A critical narrative review on stepwise treatment of high-risk infantile hemangioma with propranolol, laser, and reconstructive surgery was performed to establish who benefits, when to intervene, and how outcomes should be measured. A structured PubMed/MEDLINE search of literature published from 2016 to February 2026 was carried out, and 50 verifiable references were selected. Evidence showed that early referral, ideally before 1 month of age, is crucial because the fastest growth occurs during the first months of life. Oral propranolol remained first-line therapy; laser was useful as an adjunct for superficial components, ulceration, and residual telangiectasias; and reconstructive surgery remained indicated for residual deformity, fibrofatty tissue, scarring, or selected refractory lesions. Outcomes should be assessed with composite endpoints integrating tumor control, functional rescue, healing, safety, rebound, cosmetic sequelae, and family burden.
Keywords: Hemangioma. Propranolol. Laser Therapy. Reconstructive Surgical Procedures. Treatment Outcome.
Información del manuscrito:
Fecha de recepción: 09 de febrero de 2026.
Fecha de aceptación: 15 de abril de 2026.
Fecha de publicación: 13 de mayo de 2026.
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