Protective Effect of A Topical Powder Combining Moringa Oleifera Leaf Extract, Green Tea Extract, and Zinc Oxide on Peristomal Skin Damage Following Ileostomy: Assessment of Inflammatory Cell Density By Hematoxylin and Eosin Staining
Abstract
Peristomal skin complications are common following ileostomy formation. Repeated exposure to ileostomy effluent, moisture, proteolytic enzymes, and mechanical trauma may compromise skin barrier integrity and promote local inflammation. Moringa oleifera leaf extract, green tea extract, and zinc oxide possess biological properties that may confer anti-inflammatory and skin-protective effects. This study aimed to evaluate the effect of a topical powder combining Moringa oleifera leaf extract, green tea extract, and zinc oxide on histopathological inflammation of the peristomal skin.
This randomized, single-blind, controlled study enrolled 32 patients with newly created ileostomies, who were allocated 1:1 to the control or intervention group (n=16 each). The intervention group received a topical powder containing 15% Moringa oleifera leaf extract, 5% green tea extract, and 3% zinc oxide twice daily for seven days, whereas the control group received standard peristomal care plus placebo. On day 7, peristomal skin specimens were obtained by punch biopsy and examined using hematoxylin and eosin staining. Inflammatory cell infiltration was graded on an ordinal scale from 0 to 3. Between-group differences were assessed using the Mann–Whitney U test.
The intervention group had a lower median inflammation score than the control group [1 (range, 0–2) vs 2 (range, 0–3)]. No severe inflammation was observed in the intervention group. However, the between-group difference in inflammation scores was not statistically significant (p=0.603).
Application of the combination powder was associated with a descriptive shift toward milder peristomal skin inflammation but did not significantly reduce histopathological inflammation scores compared with control. These findings do not establish an anti-inflammatory benefit of the tested formulation and warrant further investigation in larger studies with longer follow-up and more sensitive quantitative outcome measures.
