WSW, NY, August 25th, 2026, NewsDirect
An overlooked corner of wound care may be its largest. New research sizes the U.S. market for enzyme-based debridement at roughly $4 billion by 2028, and MediWound is positioning EscharEx against a treatment that has gone unchallenged for six decades.
More than 2.5 million Americans develop pressure ulcers every year, the painful wounds and skin injuries that develop when patients are bedridden or immobilized for long periods. Most people know them as bedsores. They contribute to approximately 60,000 deaths annually and cost the healthcare system between $9.1 billion and $11.6 billion per year, according to the Agency for Healthcare Research and Quality. A single severe case can cost up to $151,700. And the problem is getting worse: globally, the absolute number of pressure ulcer cases has more than doubled since 1990, according to data from the Global Burden of Disease Study, even as age-adjusted rates have declined, a gap driven largely by aging demographics. MediWound (Nasdaq: MDWD) may have a solution, and new research is putting a number on the opportunity.
Sizing an Overlooked Market
Despite those numbers, pressure ulcers rarely come up in the biotech wound-care conversation. There is a lot of focus that goes to diabetic foot ulcers and venous leg ulcers. But new market research presented by MediWound suggests pressure ulcers may be the largest patient population of the three, and an overlooked commercial opportunity.
An estimated 6.85 million Americans are projected to be living with chronic wounds by 2028, with roughly 4 million requiring debridement, the medical process of removing dead tissue so new skin can grow. Of the almost 7 million chronic wound patients, pressure ulcer patients are projected to be the single largest group at approximately 2.75 million. The modeled U.S. addressable market for enzyme-based wound treatment across all three types is estimated at approximately $4 billion by 2028, with pressure ulcers alone representing roughly $1 billion. MediWound estimates annual peak U.S. sales potential for EscharEx at approximately $1.05 billion following expansion of the market assessment to include pressure ulcers.
Disrupting the Treatment Landscape
When a chronic wound contains dead tissue, removing it is often an important step before healing can begin. For six decades, one product has dominated that process in the U.S.: Santyl, an enzyme-based drug first approved in 1965 with annual sales exceeding $400 million, according to MediWound. In a market built around a single product that has been used for decades, the opening for a faster alternative is clear.
MediWound’s investigational biologic drug , EscharEx, uses a targeted enzyme therapy that dissolves dead tissue while leaving healthy skin intact. In the primary analysis of a Phase 2 clinical trial in venous leg ulcers, EscharEx achieved complete debridement in a median of approximately nine days. In a comparative analysis within that same trial, a subgroup of eight patients treated with Santyl achieved zero percent complete removal of dead tissue at two weeks, compared with 63 percent for the 46 patients treated with EscharEx (p=0.001). EscharEx is not approved for any indication and remains in clinical development, with a Phase 3 trial currently underway in venous leg ulcers. The global Phase 3 VALUE trial is targeting 216 patients across approximately 40 sites in the U.S., Europe and Israel, with an interim sample-size reassessment and enrollment completion expected by the end of the first quarter of 2027. Meanwhile, an investigator-initiated trial on pressure ulcers is starting towards the end of 2026.
There is clinical momentum behind the approach. A multidisciplinary panel of U.S. wound care experts, publishing in the journal WOUNDS, recently recommended that debridement should begin early in treatment and that clinicians should consider effective, less invasive approaches when appropriate. MediWound highlighted the publication in an April 2026 press release, noting that this recommendation aligns with what EscharEx is designed to do: faster, non-surgical debridement.
Where the Incentives Point
MediWound’s new market research also suggests EscharEx could reshape how wounds are treated across care settings. According to the analysis, EscharEx could expand the share of debridement procedures using enzymatic approaches from approximately 19 percent to 31 percent, drawing volume from surgical, mechanical, and other methods. Much of the pressure ulcer population resides in skilled nursing facilities and long-term care, settings where sharp or surgical debridement is less commonly used. In these facilities, deficiencies in pressure-ulcer prevention or treatment can contribute to enforcement actions, including civil monetary penalties, while pressure-ulcer outcomes are also incorporated into CMS quality ratings. In hospitals, the financial incentives to improve pressure-ulcer care are also significant. Since 2008, Medicare has limited additional hospital payment when Stage III or IV pressure ulcers develop during an inpatient stay and were not present on admission. Together, those policies give providers an economic as well as clinical incentive to prevent worsening wounds and improve treatment efficiency.
If EscharEx ultimately demonstrates efficacy in pressure ulcers and is approved for that use, those incentives could support adoption across these settings. There is no guarantee that ongoing or planned clinical trials will succeed, and the pressure ulcer opportunity still depends on a study that has not yet begun. But in a market that has had one dominant product for sixty years, with a growing patient population and billions in unmet treatment costs, the setup is hard to ignore. For investors watching the wound care space, the market research suggests the addressable opportunity could be substantial.
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