Perhaps the most remarkable property of HOCl is its ability to destroy biofilms. Many wound care clinicians and burn specialists have come to realize the simple concept of wound colonization, critical colonization, and infection de- pendent on classification by number of colony forming units of bacterial species per weight or volume of tissue is naïve in practice. Biofilms can contain anaerobes,

which often are missed by classical culture techniques and grow by contiguous spreading or shedding of planktonic bacteria, seeding onto surrounding surfaces, and resulting in infection dissemination. Biofilms are also notorious for their persistence, being resistant to the host immune system, systemic antibiotics, and topical antimicrobials. Although it was thought that inability to penetrate the extracellular material barriers was the reason for failure of antibiotics to clear biofilms, in vitro evidence is increasing to suggest antibiotics are able to slowly diffuse through the biofilm matrix. Thus, mechanisms such as alteration of activity status (dormancy) and triggering of mutations and gene expression by environmental stress, bacterial density, nutrition supply, and oxidative stress may be responsible for antibiotic resistance.