Chronic wounds predominantly affect patients aged older than 60 years, and with the aging of the population, their prevalence will continue to increase. Most chronic wounds are invariably colonized, and therefore, superficial swabs cultures should be avoided. Ideally, quantitative or semiquantitative tissue cultures should be obtained to guide antibiotic therapy. Topical antibiotics are not recommended in most guidelines because they can provoke delayed hypersensitivity reaction, super infection and, more importantly, select for resistance. The study of biofilms has emerged over the past three decades in various disciplines such as biotechnology, bioengineering, or infectious disease research, leading to rapid progress, but also fragmentation and duplication of effort. Presently, included among these novel weapons of microdestruction are molecular blockading techniques, electrical enhancement of anti-infective and bacterial interference. Future treatments of infections must ultimately target these reservoirs of infection aiming for their complete eradication.

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