 AIM 2: Compare the expression patterns of the local and systemic inflammatory biomarkers over time and determine if there is a correlation with the microbiota pattern to diagnose the state of wound healing at the skinimplant interface and the systemic response to a potentially life-long chronic wound. The measurements of the pro-inflammatory cytokines, found in the stomal exudate local biomarkers and blood serum systemic biomarkers, along with evolving microbiota profiles Aim 1 will help to better characterize the homeostatic state of the stoma and subsequent optimum wound care therapies. 