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Anti-inflammatory effects were also reported by the downregulation of neutrophil L-selectin (SELL) and elastase (ELANE), which are associated with neutrophil accumulation and the development of chronic skin wounds ( Estrogen was also shown to play a crucial role in controlling oxidative stress, a major contributor to impaired wound healing, by increasing the production of antioxidants, such as superoxide dismutase (SOD), and promoting B-cell lymphoma 2 (BCL2) expression, via activation of the nuclear factor erythroid 2-related factor (NRF2) (Kanda and Watanabe, 2003

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Sensitivity analysis determined that no particular study likely affected the pooled results