Beyond Burns: NexoBrid's Enzymatic Precision Targets Trauma Wounds

YAVNE, Israel – December 10, 2025 – For years, MediWound's NexoBrid® has been a critical tool in specialized burn units, a biologic drug that enzymatically removes dead tissue from severe thermal burns. Now, compelling new clinical data reveals a powerful new application for the treatment, one that could shift its use from the burn unit to the frontline of trauma care: preventing the permanent disfigurement known as “traumatic tattoos.”

In a peer-reviewed study published in the Journal of Burn Care & Research, NexoBrid demonstrated a remarkable ability to remove foreign particles like asphalt, glass, and metal shrapnel embedded in the skin from accidents and explosions. The findings signal a significant strategic pivot for MediWound, potentially unlocking a vast new market in trauma care and positioning its enzymatic technology as a disruptive force against decades-old treatment methods.

The Clinical Challenge of Traumatic Tattoos

Far from a chosen aesthetic, traumatic tattoos are the permanent, often disfiguring, result of high-velocity injuries. When accidents or blasts drive foreign debris deep into the skin, the body's healing process can permanently seal it in place, leaving behind a dark, mottled pattern. The consequences extend far beyond cosmetic concerns. These embedded particles can lead to chronic inflammation, increased infection risk, and functional impairment.

The psychological toll is equally severe. Survivors are often left with a permanent, visible reminder of their trauma, which can profoundly impact self-perception and mental health. The current standard of care for these acute injuries often relies on aggressive mechanical scrubbing—a physically demanding and non-selective process that can damage surrounding healthy tissue and frequently fails to remove all the particles.

Alternative methods, such as dermabrasion or surgical excision, carry their own risks of scarring. While advanced laser systems can be effective at breaking down embedded pigments, they are typically used on healed, chronic tattoos over multiple expensive sessions, not in the critical hours immediately following an injury. This leaves a significant unmet need for a treatment that can be applied acutely to prevent the tattoo from ever becoming permanent, while preserving as much healthy tissue as possible.

A Paradigm Shift in Debridement

NexoBrid represents a fundamental shift away from these crude mechanical approaches toward a more precise, biological solution. Derived from bromelain, an enzyme found in pineapple stems, the treatment works by selectively dissolving non-viable, damaged tissue without harming healthy, living cells. This precision is what makes it so promising for the irregular and unpredictable wounds caused by trauma.

The new prospective study, conducted at Sheba Medical Center in Israel, put this capability to the test. Fifteen patients with traumatic tattoos from friction and blast injuries first underwent standard mechanical scrubbing. The remaining embedded pigment was then documented before NexoBrid was applied at the bedside. The results, quantified using computer-based image analysis, were striking.

On average, the pigmented wound area was reduced by over 92%, from 37.5% of the surface post-scrubbing to just 2.1% after the enzymatic treatment. For abrasive “road rash” injuries, 96% of visible pigments were removed. Even in complex blast injuries, pigment load was reduced by 84%. The treatment was well-tolerated and performed without the need for an operating room.

“In blast injuries and friction burns, where wound depth is highly irregular, NexoBrid provides the precision these cases demand,” noted Professor Josef Haik, Director of the Burn Center at Sheba Medical Center and an investigator in the study. He explained that the selective enzymatic action removes particles embedded within damaged skin layers, revealing a clean wound bed that allows clinicians to better assess the injury and plan the next steps. This is a level of finesse that mechanical methods simply cannot match.

A New Strategic Frontier for MediWound

The business implications of this new data are profound. For MediWound, a company whose identity has been closely tied to the thermal burn market, this represents a major opportunity for strategic diversification. Proving NexoBrid's utility in a completely different vertical—acute trauma—dramatically expands its addressable market beyond the estimated 100,000 annual hospitalizations for severe burns in the U.S. and Europe. The new potential patient population includes countless victims of road accidents, industrial mishaps, and violent conflicts worldwide.

This expansion showcases the versatility of MediWound's underlying enzymatic platform, which it is also developing for chronic wounds with its late-stage candidate, EscharEx®. By demonstrating success in multiple, distinct high-value indications, the company strengthens its value proposition and reduces its reliance on a single market. This move could attract significant investor interest by recasting MediWound not just as a burn care company, but as a broader leader in innovative tissue repair.

If NexoBrid becomes a standard of care for preventing traumatic tattoos, it would establish a powerful competitive moat. Its unique mechanism offers a clear advantage in the acute setting over both traditional scrubbing and delayed laser treatments, addressing the problem at its source before permanent disfigurement sets in.

Bolstering National Preparedness

The study’s focus on blast injuries carries another layer of strategic significance, particularly in the context of MediWound’s long-standing partnership with the U.S. Biomedical Advanced Research and Development Authority (BARDA). BARDA, tasked with securing the nation against mass casualty events, has already invested heavily in NexoBrid, procuring it for the national stockpile as a medical countermeasure for both thermal burns and chemical burns from agents like sulfur mustard.

BARDA’s strategic priorities explicitly include developing countermeasures for burn and blast trauma. The ability of NexoBrid to effectively treat a key consequence of explosive events aligns perfectly with this mandate. An effective, easy-to-use treatment that can be deployed at the bedside to reduce long-term morbidity in a mass casualty scenario is precisely the type of innovation BARDA seeks to support.

While no new funding for this specific indication has been announced, the data provides a compelling case for expanding the collaboration. This alignment elevates NexoBrid from a commercial therapeutic to a potential asset for national security and disaster preparedness, further solidifying its strategic importance.

As the study's authors rightly call for, larger controlled trials are needed to confirm the long-term cosmetic outcomes and fully define NexoBrid's role in complex trauma protocols. However, this initial data provides a powerful glimpse into a future where a pineapple-derived enzyme could become a standard tool in every trauma bay, preventing lifelong scars for survivors of an accident or attack.