The Role of Thermal Immunomodulation in Postoperative Wound Repair with a Focus on Hepatic Surgery

Controlled local hyperthermia supports postoperative wound healing in liver surgery by stimulating metabolism, angiogenesis, and immune responses through the induction of heat shock proteins (HSPs) and modulation of Damage-Associated Molecular Patterns (DAMPs). This study evaluates the impact of thermal modulation on immune processes during abdominal wound repair, specifically analyzing the role of HSPs and immune activation pathways. A narrative review of the literature from 2010 to 2025 was conducted to summarize molecular mechanisms regarding temperature, HSP activation, cytokine expression, and DAMPs, excluding studies conducted solely in animal models. The results indicate that precise local hyperthermia in postoperative abdominal wounds activates HSPs as well as inflammasome and Toll-like receptor (TLR) pathways, modulating immune and cytokine responses depending on the type and depth of tissue injury. Consequently, such thermoimmunomodulation stabilizes immune cell functions, optimizes the balance between inflammation and regeneration, and minimizes the risk of postoperative complications to support effective wound healing.