Wound healing is a complex process that can be interrupted or impaired by a variety of factors. This article will focus on the microbial bioburden in chronic wounds. The classic signs of infection may not be obvious in patients who are immunocompromised, such as people with diabetes mellitus, those with peripheral vascular disease, or those taking medications that dampen inflammation, such as steroids. That is why clinicians and patients should be aware of the secondary signs and symptoms of wound infection. The International Wound Infection Institute (IWII) presents ten top tips focusing on the identification of wound infection in a chronic wound.