The article is devoted to the analysis of the qualitative composition and dynamics of the microbiological landscape in the treatment of chronic soft tissue wounds. The purpose of the study is to study the changes in the quantitative and qualitative composition of pathogens of wound infection in the treatment of patients with chronic soft tissue wounds in a surgical hospital. Materials and methods . In order to study changes in the quantitative and qualitative composition of pathogens of wound infection in the treatment of patients with chronic soft tissue wounds, a retrospective analysis of bacteriological studies was performed in 206 patients with chronic soft tissue wounds. Results . After the wound defect was closed by the method of free skin grafting with a split graft, pathogen change on the 4-5th day occurred in 59% of cases. Lysis and melting of the graft in the group of patients with a change of microflora were observed in 37,5% of cases. Most often, these complications were associated with the presence in the wound of St. pyogenes and non-fermentative gram-negative bacteria. Conclusions . In patients with chronic soft tissue wounds, associations of microorganisms are detected in 13,5% of cases; S. aureus is the main causative agent among monocultures of microorganisms (32,5%). The presence of a wound Ps. aeruginosa, Acinetobacter spp., Streptococcus pyogenes (serogroup A) is a contraindication to skin-plastic surgery.