MediWound's NexoBrid® Demonstrates 92.5% Reduction in Traumatic Tattoos from Blast and Abrasion Injuries
Key Insights
MediWound announced peer-reviewed clinical data showing NexoBrid® reduced pigmented wound surface by 92.5% in patients with traumatic tattoos (search) from friction and blast injuries (search).
The prospective study of 15 patients at Sheba Medical Center demonstrated that NexoBrid® removed 96% of visible pigments in abrasive injuries and 84% in explosive injuries.
The enzymatic debridement treatment was well-tolerated with no adverse events, offering a precision alternative to aggressive mechanical scrubbing for embedded particle removal.
MediWound Ltd. has announced promising clinical data demonstrating that its FDA-approved biologic NexoBrid® substantially reduces embedded particles associated with traumatic tattoos (search) following abrasion and blast injuries (search). The peer-reviewed study, published in the Journal of Burn Care & Research, showed a 92.5% reduction in pigmented wound surface area compared to post-scrubbing baseline.
Clinical Study Results
The prospective independent study, conducted at Sheba Medical Center's National Burn Center, enrolled 15 patients aged 4-51 years diagnosed with traumatic tattoos (search) resulting from friction or blast injuries (search). After standard mechanical scrubbing to remove loose debris, patients were treated with NexoBrid within 24 hours of injury under procedural sedation.
The mean pigmented wound area decreased from 37.5% before NexoBrid application to 2.1% afterward, representing a 92.5% reduction in pigmented wound surface. Every patient showed substantial clearance of foreign particles, with treatment demonstrating differential effectiveness based on injury type: abrasive injuries showed an average 96% removal of visible pigments, while pigment load in explosive injuries was reduced by 84%.
"In blast injuries (search) and friction burns, where wound depth is highly irregular, NexoBrid provides the precision these cases demand," said Professor Josef Haik, MD, MPH, Director of the Department of Plastic and Reconstructive Surgery and Burn Center at Sheba Medical Center. "We believe the effectiveness of NexoBrid is driven by its selective enzymatic action on damaged skin layers, which helps remove many of the particles embedded within them."
Treatment Protocol and Safety Profile
The treatment protocol involved applying NexoBrid in a 1-3 mm layer to affected areas under occlusion for four hours, followed by removal and repeated gentle scrubbing to reveal a clean wound bed. Pigment reduction was quantified using ImageJ software by comparing pre- and post-treatment photographs.
Treatment was well tolerated and performed at bedside, with no treatment-related adverse events reported during the early post-procedure period. The authors noted this represents the first published series to specifically evaluate enzymatic debridement with NexoBrid for the prevention of traumatic tattoos (search).
Clinical Context and Unmet Need
Traumatic tattoos (search) occur when high-velocity accidents or blasts drive materials such as asphalt, dirt, glass, or metallic particles into the skin, often causing permanent dark discoloration, aesthetic deformities, functional impairment, and increased risk of inflammation or infection. Current standard of care relies on aggressive non-selective mechanical scrubbing, which may leave embedded particles behind and risk damage to viable tissue.
Professor Haik noted that in high-energy explosions, some debris may remain lodged in deeper tissues, yet NexoBrid consistently reveals a clean, well-defined wound bed, enabling clinicians to determine appropriate next steps.
Study Limitations and Future Directions
The investigators acknowledged the small sample size and short follow-up as study limitations, calling for larger, controlled studies to confirm NexoBrid's impact on long-term cosmetic outcomes and to further explore combined approaches in complex trauma injuries.
About NexoBrid®
NexoBrid® is a topically administered, biological orphan drug for the enzymatic removal of eschar in patients with deep partial- and full-thickness thermal burns (search). It selectively removes non-viable tissue while preserving viable tissue and is approved for use in adults and pediatric patients in over 40 countries, including the United States, European Union, and Japan. NexoBrid development has been supported with federal funds from the Biomedical Advanced Research and Development Authority (BARDA (search)).