Although more than 80% of infected and 70% of noninfected leg ulcers have been shown to harbor anaerobic organisms, their role in mediating impaired wound healing in the skin is frequently overlooked. There is now increasing evidence that the gram-positive anaerobic cocci play a role (both directly and indirectly) in mediating impaired wound healing in vivo. This article discusses the mechanisms by which these microorganisms may interfere with the inflammation, repair, and remodeling phases of the wound healing process. (WOUND REP REG 2002;10:–353)