The purpose of this study is to identify predictability of wound flora which may be helpful in the selection of empiric antibiotic therapy of wound infections while awaiting the results of bacterial cultures. Toward this end, results of an ongoing microbiologic surveillance of skin wound flora in hospitalized dermatology patients are presented. Bacterial isolates cultured from patients with skin wounds admitted to a tertiary care dermatology inpatient unit were evaluated and comparison was made to a previous survey of the same inpatient service done in 1992. Microbiologic evaluation of superficial skin wounds, leg ulcers, and pressure ulcers showed that Staphylococcus aureus was the principal isolate in superficial wounds (77%) compared to the equal prevalence of S. aureus (43%) and Pseudomonas aeruginosa (42%) cultured from leg ulcers. Cultures from pressure ulcers grew Proteus mirabilis as the dominant isolate. These data agree with previous surveillance data from the same inpatient base performed in 1992 and support the relatively predictable wound flora cultured from skin wounds in our hospital inpatient unit over the 4 years surveillance period. This predictability can enhance empiric antibiotic selection for wound infections while awaiting the results of bacterial culture, and supports the value of local microbiologic surveillance programs in the management of wound infections.