In 2008 the National Institute for Health and Clinical Excellence (NICE) launched their clinical guideline 74 on the prevention and treatment of surgical site infections (SSI). Clinical guideline 74 predominately advocates and advises on SSI prevention and treatment. This article explores some of the questions raised by this clinical guideline around the areas of SSI surveillance, gaps in the evidence, and the management/effectiveness of clinical guidelines in practice. It is posited that these questions create exciting challenges for wound care clinicians in the quest to answer them.