Striking evidence from animal studies dating back to 1962 that estrogens play a crucial role in cutaneous wound healing and repair is reported. Characteristic of both chronic wounds and acute wounds that fail to heal are excessive leukocytosis and reduced matrix deposition. Estrogen is a major regulator of wound repair that can reverse age-related impaired wound healing in humans.
A systematic search by Dr Eva V. Vodegel MD and team has revealed that estrogen therapy has a positive effect on vaginal wound healing. However future studies are required to determine whether oestrogen therapy has the potential to improve surgical outcomes.
The findings of the study are published in Neurology and Urodynamics.
The objective of the study was to determine the effects of oestrogen or oestrogen deprivation on vaginal wound healing.
The study was a systematic search of OVID MEDLINE, OVID Embase, and Web of Science was conducted up to January 28, 2020. They included original studies comparing wound healing-related outcomes of oestrogen exposed subjects (female animals and women) to hypo-oestrogenic subjects after vaginal surgery. Data on wound healing-related outcome measures were extracted. For each individual comparison, the standardised mean difference (Hedges' g; SMD) and 95% confidence interval (CI) were calculated.
The results of the study were
• A total of the 1474 studies were reviewed, 14 studies were included for review, and 11 provided data for meta-analysis.
• Oestrogen improves neovascularisation (SMD: 1.13, 95% CI: 0.67–1.60), microscopic wound closure (SMD: 0.98, 95% CI: 0.66–1.29), collagen synthesis (SMD: 1.08, 95% CI: 0.42–1.74), and tissue strength (SMD: 1.26, 95% CI: 0.53–1.99) in animals.
• Oestrogen increases granulation (SMD: 1.67, 95% CI: 0.54–2.79) and accelerates macroscopic wound closure (SMD: 1.82, 95% CI: 1.22–2.42) in women and animals.
• Oestrogen decreases the inflammatory response (SMD: −0.58, 95% CI: −1.14 to −0.02) in women and animals and reduces levels of transforming growth factor (TGF)-β1 (SMD: −1.68, 95% CI: −2.52 to −0.83) in animals. All results were statistically significant.
Dr Vodegel and team concluded that "Oestrogen therapy has a positive effect on vaginal wound healing. Future studies should determine whether oestrogen therapy has the potential to improve surgical outcomes."
Reference: https://doi.org/10.1002/nau.24819