Mechanisms of extracorporeal shock wave therapy in burn scar repair: Advances in immunoactivation-based scar remodeling research.

Extracorporeal Shock Wave Therapy (ESWT) plays a key role in burn scar treatment through its immunoregulatory effects, influencing inflammation, fibrosis remodeling, and angiogenesis. These mechanisms collectively mediate scar repair, highlighting the importance of ESWT in restoring tissue homeostasis. However, its clinical efficacy depends on precise optimization of parameters such as energy flux density, pulse frequency, and treatment duration. Without proper adjustments, its therapeutic potential may be limited. This review systematically explores ESWT-mediated immunoregulation in scar formation and repair, addressing its impact on inflammatory responses, tissue fibrosis, and abnormal angiogenesis. Furthermore, we discuss challenges in optimizing treatment parameters, developing personalized strategies, and enhancing clinical translation. By focusing on immunoactivation signaling pathways, this review provides mechanistic insights into ESWT's role in burn scar management and underscores its potential for precision therapy. Ultimately, it offers a theoretical foundation and practical guidance for advancing standardized clinical applications of ESWT.