Thermotherapy for Chronic Wounds: A Wound-Interface Translation Framework for Materials, Devices, Clinical Evidence, and Validation Requirements

This is the authors' abstract. We don't add key points for this paper.

Interest in local warming for chronic wound care has re-emerged as flexible heaters, embedded sensors, and smart dressings make controlled heat delivery increasingly feasible. This narrative translational review treats thermotherapy as a dose-dependent wound-interface intervention rather than a single warming technology. It distinguishes normothermic radiant warming, water-filtered infrared A, resistive Joule heating, photothermal systems, and temperature-monitoring technologies by mechanism, thermal context, therapeutic purpose, and evidence level. The review integrates wound pathophysiology, biological responses to temperature, thermal-dose concepts, emerging heater platforms, sensing and closed-loop control, clinical evidence, safety, and regulatory translation. Direct human treatment evidence remains concentrated in small historical radiant-warming and water-filtered infrared A studies, with limited additional local-heat evidence, and cannot be transferred directly to contemporary flexible, wireless, or photothermal platforms. For lower-temperature warming, heater setpoint alone is an inadequate dose descriptor, and the biological meaning of cumulative equivalent minutes at 43 °C (CEM43) has not been validated; measured time–temperature profiles, peak temperature, spatial variation, sensor location, and uncertainty are more informative. Clinical translation therefore depends on reproducible wound-interface dosing under realistic moisture, pressure, perfusion, dressing, motion, and workflow conditions, together with wound-specific dose models, transparent reporting, realistic interface validation, and architecture-specific regulatory evidence.