WSW, NY, November 10th, 2026, NewsDirect
Without the deal, Smith+Nephew leans harder on what it already owns, including SANTYL, a $400 million wound drug its own CEO calls slow. MediWound (NASDAQ: MDWD) is testing a faster one in Phase 3.
Smith+Nephew (NYSE: SNN), the British maker of hip and knee implants and wound care products, was in advanced talks to merge with the orthopaedics business of Johnson & Johnson (NYSE: JNJ), in a combination the Financial Times put at roughly $34 billion. On October 23, Reuters and the FT reported that the talks had collapsed. The two sides had reportedly agreed on the main terms. What they could not agree on was who would be CEO. On November 4, in its third-quarter trading update, Smith+Nephew confirmed it had approached Johnson & Johnson earlier in the year and that “those conversations have now ended.”
Without the deal, Smith+Nephew now has to look for growth in the businesses it already owns. One of them is a wound drug called SANTYL, and it has a weakness that a small Nasdaq company, MediWound (NASDAQ: MDWD), has spent years working to fix: it is slow.
Smith+Nephew’s Slow Bestseller
SANTYL is an ointment used in U.S. clinics to clear dead tissue from chronic wounds, such as leg ulcers caused by poor circulation. That step, called debridement, has to happen before a wound can start to heal. Smith+Nephew got SANTYL in 2012, when it bought its maker, Healthpoint, for $782 million in cash. Today it is the only FDA-approved biologic drug for enzymatic debridement, with 2025 sales of more than $400 million, according to MediWound’s corporate presentation.
It has had a harder year than usual. In the second quarter, the Smith+Nephew bioactives unit that includes SANTYL saw revenue fall 12.7% on an underlying basis, mostly because of new reimbursement rules for skin substitutes, and the company cut its full-year growth outlook. At the time, management said it expected SANTYL to return to growth in the third quarter. Indeed, in the November 4 trading update, the company confirmed SANTYL “returned to modest growth following the weak Q2,” which it attributed to the product’s normal quarterly volatility, bucking a further 8.8% underlying decline in that same unit on the skin-substitute reimbursement headwind.
The more revealing moment came during the Q2 earnings call. Asked about competition, CEO Deepak Nath called SANTYL “a multiple hundred million dollar product” that needs no refrigeration and causes little pain. Its drawback, in his words: “it is a slower process.” With SANTYL, clearing a wound can take weeks of daily applications, and every extra week means more nurse visits for patients who are often elderly or diabetic, and more cost for the clinics treating them. Nath said a faster version is in development, without giving a timeline.
Smith+Nephew’s Own Fast Enzyme Is Still Early
One fast-acting enzyme candidate publicly tied to Smith+Nephew is SN514, developed by SERDA Therapeutics, which describes itself as a wholly owned subsidiary of Smith+Nephew. Its only registered clinical trial, an early-stage study in burns, is now listed as terminated, for administrative reasons rather than safety, in a record updated on October 30. No SN514 trial in chronic wounds appears on ClinicalTrials.gov.
Meet the Company Already in Phase 3
That is where MediWound comes in. The Israeli company is not new to enzyme drugs: it already sells NexoBrid, an FDA-approved biologic that removes dead tissue from severe burns, in the U.S., Europe and Japan. Its next product, EscharEx, applies the same kind of technology, an enzyme derived from pineapple stems, to chronic wounds. The investigational drug is designed to clear dead tissue in days rather than weeks.
MediWound has already tested it against SANTYL. In a published post hoc analysis of its Phase 2 trial in venous leg ulcers, 63% of EscharEx patients reached complete removal of dead tissue within two weeks, against 0% on SANTYL. Median time to a wound ready to heal was 11 days with EscharEx; the SANTYL group never reached that median during the 12-week study. By 12 weeks, 78% of EscharEx patients had a wound ready to heal, against 38% on SANTYL. While the SANTYL group was small, eight patients, the gap was statistically significant and matches Smith+Nephew’s own description of its product.
EscharEx is now in VALUE, a 216-patient, placebo-controlled Phase 3 trial at about 40 sites in the U.S., Europe and Israel. In September, an independent safety board recommended the study continue without modification, and MediWound expects to complete enrollment and a planned interim sample-size review by the end of the first quarter of 2027.
The Numbers Side by Side
Smith+Nephew paid $782 million for the business that brought it SANTYL, a product now selling more than $400 million a year. Based on independent third-party market research, MediWound cites U.S. annual peak sales potential for its SANTYL challenger EscharEx of around $1B. EscharEx’s very fast debridement could address the same key issue identified by S&N. MediWound, with an FDA-approved burn drug on the market and EscharEx in Phase 3, was valued at about $171 million at the October 30 close.
The collapse of the J&J talks turned attention to what Smith+Nephew already owns, and in wound care that means a bestseller its own CEO calls slow. On November 4 the company confirmed SANTYL returned to modest growth, but that does not make it faster. MediWound reports its own results on November 12 and expects Phase 3 enrollment and the interim review by the end of the first quarter of 2027. While the trial still has to deliver, a company valued at less than a quarter of what Smith+Nephew paid for SANTYL’s maker looks like one of the more interesting names in wound care to keep following.
Recent News Highlights from MediWound (NASDAQ: MDWD)
MediWound to Report Third Quarter 2026 Financial Results
Independent DSMB Recommends MediWound’s EscharEx Phase III VALUE Study Continue Without Modification
MediWound to Present at the H.C. Wainwright 28th Annual Global Investment Conference
MediWound Reports Second Quarter 2026 Financial Results and Provides Corporate Update
MediWound to Report Second Quarter 2026 Financial Results
MediWound Reports First Quarter 2026 Financial Results and Provides Corporate Update
Newly Published U.S. Expert Consensus Aligns with MediWound’s Strategy for Chronic Wound Debridement
MediWound to Present New EscharEx Data at Leading Wound Care Conferences
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