Biofilms are slowly becoming recognised as a cause of wound infection. Typically, the biofilm delays healing without inducing a dramatic host response. Biofilms may be unperturbed by antimicrobial or neutrophil attack and can survive in a relatively harsh environment, resisting attempts at removal. Their presence is often associated with chronic wounds but they can also be involved in acute wound infection. Acknowledging their presence as a potential cause of surgical site infection may explain the sometimes disappointing response obtained from traditional approaches such as promoting drainage, systemic antibiotics or delayed closure.