{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T14:16:33Z","timestamp":1781360193028,"version":"3.54.1"},"reference-count":55,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2019,8,2]],"date-time":"2019-08-02T00:00:00Z","timestamp":1564704000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","award":["1I01RX001544\u201001A1"],"award-info":[{"award-number":["1I01RX001544\u201001A1"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal Orthopaedic Research"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Percutaneous osseointegrated (OI) prostheses (POPs) are used to skeletally\u202fattach artificial limbs in amputees. While any permanent percutaneous interface is at risk of becoming infected by the resident microbiota colonizing the stoma, most of these patients remain infection\u2010free. Avoidance of infection likely depends upon a mechanically and\/or biologically stable skin\u2010to\u2010implant interface. The ultimate question remains, \u201cwhy do some stomata become infected while others do not?\u201d The answer might be found in the dynamic bacterial communities of the patient and within the stomal site itself. This study is an appendix to the first Food and Drug Administration approved prospective early feasibility study of OI prosthetic docking, in which, 10 transfemoral amputees were implanted with a unique POP device. In this analytical, longitudinal cohort study, each patient's skin and stomal microbiota were analyzed from the initial surgery to 1 year following the second\u2010stage surgery. During each follow\u2010up visit, three swab samples\u2014stomal, device thigh skin and contralateral thigh skin\u2014were obtained. DNA was extracted, and bacterial 16S ribosomal RNA (rRNA) genes were amplified and sequenced to profile microbial communities. The stomal microbiota were distinct from the microbiota on the adjacent thigh skin and the skin of the contralateral thigh, with a significantly increased abundance of <jats:italic>Staphylococcus aureus<\/jats:italic> within the stoma. Early on stomal microbiota were characterized by high diversity and high relative abundance of obligate anaerobes. Over time, the stomal microbiota shifted and stabilized in communities of lower diversity dominated by <jats:italic>Streptococcus<\/jats:italic>, <jats:italic>Corynebacterium<\/jats:italic>, and\/or <jats:italic>Staphylococcus spp<\/jats:italic>. \u00a9 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. 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