<p>Our understanding of the factors that delay wound healing continues to improve through advances in research into the microenvironment. There is now strong evidence that biofilm is present in the majority of chronic wounds. The pathogenesis of biofilms continues to be evaluated, but current knowledge suggests they are detrimental to wound healing and degrade the extracellular matrix. We acknowledge that there are gaps in the evidence and significant debate continues on how best to move the current understanding forward.</p>