Israeli treatment that spared burn surgeries now aims to save limbs

Diabetes patients, and not only them, suffer from chronic wounds that do not heal, which sometimes end in limb amputations. An Israeli drug, which has already revolutionized the treatment of burns, intends to change the situation.

This is a problem that affects millions of patients around the world. Chronic wounds that do not heal.

The Israeli technology that recently changed the way severe burns are treated around the world is facing a new and especially ambitious medical challenge. After helping treat many dozens of injured people during the Swords of Iron War and, often, sparing complex surgeries, MediWound, based in Yavne, is now launching a large-scale global study aimed at addressing one of the most difficult and frustrating problems in modern medicine: chronic wounds that do not heal.

These are wounds that can remain open for months and even years, cause severe pain, recurrent infections, serious impairment to quality of life, and sometimes even lead to limb amputations and death.

As part of the new VALUE study, the company will recruit 216 patients at leading medical centers in the United States, Europe, and Israel. The purpose of the trial is to examine the efficacy and safety of the investigational drug EscharEx, which is based, as mentioned, on technology originally developed for the treatment of severe burns.

MediWound, which employs approximately 120 people in Israel and around the world, has recently become a well-known name in the field of burn medicine thanks to NexoBrid, a drug based on enzymes extracted from the stem of the pineapple plant. The treatment enables the selective removal of dead and damaged tissue without harming the healthy tissue around it.

“In the past, the treatment of severe burns involved complex surgeries, anesthesia, and sometimes also skin grafts,” says the company’s CEO, Ofer Gonen, in a conversation with Walla. “Our drug knows how to remove only the damaged tissue. In doing so, it reduces the need for aggressive surgical intervention and enables a better healing process.”

The drug was approved by the FDA at the end of 2022 and is currently approved for use in more than 40 countries around the world.

To prepare the This treatment prepareshealing and closure. The Israeli treatment for chronic wounds / PR

The Swords of Iron War turned the treatment into one of the important tools in Israel’s medical arsenal. According to Gonen, a significant percentage of those wounded in the war suffered from burns of varying degrees of severity, and a large portion of them were treated using the technology developed by the company.

“There are approximately about 10% of the wounded who suffered from significant burns,” he says. “In many cases, we were able to spare surgeries and improve the medical and aesthetic outcome.”

The experience gained during the war also attracted attention outside Israel. About a month ago, the company signed a strategic agreement worth approximately $200 million with the United States government, under which the U.S. will stockpile a strategic reserve of the drug for emergency cases and mass-casualty events.

“When there is a mass-casualty event with hundreds of injured people, you cannot bring everyone into operating rooms,” Gonen explains. “The drug enables fast and effective treatment even under complex conditions.”

Now the company seeks to apply the same therapeutic approach in a completely different field.

Chronic wounds are wounds that fail to complete the natural healing process. They are especially common among diabetes patients, older adults, and people suffering from vascular problems.

According to estimates, more than four million people in the United States suffer from chronic wounds. In Israel, this involves thousands of patients.

“These wounds accompany people for months and sometimes years,” says Gonen. “They are painful, emit an unpleasant odor, limit function, and severely harm quality of life.”

“These wounds accompany people for months and sometimes years.” Ofer Gonen, CEO of MediWound

EscharEx is based on the same enzymatic technology but is specially adapted to the needs of chronic wounds.

“We remove all the non-viable tissue that prevents the wound from healing,” Gonen explains. “In burns, you want to act quickly and more aggressively. In a chronic wound, the goal is to be gentle, reduce side effects, and allow the patient to continue their daily routine.”

According to him, the treatment is limited in time and is not intended for prolonged use. “It is a series of up to eight treatments over one to two weeks. The goal is to prepare the wound for healing and closure.”

The study has already begun operating in Israel. At this stage, the participating medical centers are Sheba, Kaplan, Shamir, and Beilinson, and an additional medical center is expected to join later.

“We hope to complete recruitment of all 216 patients by the end of the first quarter of 2027,” says Gonen. “Several dozen of them will be from Israel.”

One of the principal investigators in the study is Prof. Yossi Haik, Director of the Division of Plastic Surgery, the National Burn Center, and the Skin Bank at Sheba Medical Center.

According to him, the central idea behind the treatment is to allow the wound to return and enter an active healing process. “A chronic wound is essentially a wound that got stuck,” explains Prof. Haik. “We clean it very precisely and remove only the damaged tissue. In doing so, we give it a new opportunity to restart the healing process.”

According to Prof. Haik, this is a critical stage before any other advanced treatment. “It does not matter whether special dressings, hyperbaric chambers, or other technologies are used. First of all, you need a clean wound.”

Prof. Haik admits that when the technology was first presented two decades ago, many in the medical community regarded it with skepticism. “We were very skeptical about this drug,” he says. “But today we know that the treatment saved about 60% of the burn surgeries we would have performed in the past.”

According to him, the experience accumulated in burns provides a strong scientific and medical basis for expanding use into the field of chronic wounds as well. “If it is possible to avoid surgery through a topical treatment and achieve a similar or even better result, that is a dramatic change. This technology has already changed once the way burns are treated. Now we are examining whether it can do the same thing for patients who have been living for years with wounds that do not heal.”

Chronic wounds are considered one of the most expensive and complex problems in healthcare systems around the world. They require frequent clinic visits, prolonged treatments, and sometimes repeated hospitalizations.

According to Prof. Haik, every wound is unique. “I have more than 30 years of experience in the field, and I can say that no two wounds are identical. Every patient brings a different medical story and different challenges.”

He explains that today, the options for cleaning a wound are relatively limited and include mainly surgical intervention, chemical substances, and additional methods. “Surgery is an important tool, but it is not always the right solution. This is especially true for older or complex patients. Here there is an option to clean the wound very precisely, without harming the healthy tissue.”

If the current study succeeds, the Israeli technology that has already revolutionized burn treatment may do so again, this time for millions of people worldwide who live with hard-to-heal wounds that harm their quality of life every day.