Background: Reconstructive surgery aims to restore form and function. Despite technological advances and specialised expertise, complications such as surgical site infections (SSIs), delayed healing and graft failure remain challenges both for patients and their surgeons.[1] Recent research suggests the cutaneous microbiome plays an important role in wound healing but gaps in knowledge persist within this subject. Purpose: To investigate the relationship between human skin microbiome and wound healing in reconstructive surgery, focusing on graft integration, tissue regeneration and infection rates. Method: A targeted literature search was conducted using Google Scholar and PubMed. Search criteria included microbiome, wound healing, reconstructive/plastic surgery, graft, tissue regeneration and infection. The thirty most relevant studies were analysed. Conclusion: This review demonstrates the critical role of the skin microbiome, specifically diversity and composition, and its significance in wound healing. Notable findings were that traumatic injuries, in particular burns, led to microbiome dysbiosis, with subsequent poor graft outcomes and delayed healing.[2] Preoperative antibiotic courses appeared to increase SSI risk due to reduction of protective commensal bacteria, which maintain immune responses and the skin’s barrier functions. Further research into the relationship and interventions to enhance healing could optimise wound outcomes for all surgical patients. References 1.Plichta, J. et al(2017). Cutaneous Burn Injury Promotes Shifts in the Bacterial Microbiome in Autologous Donor Skin: Implications for Skin Grafting Outcomes. Shock (Augusta, Ga.), 48(4), 441–448 2.Yang, Y. et al(2024). The role of the skin microbiome in wound healing. Burns & Trauma, 12