An innovative gel, derived from pineapple stems, is being used to treat severe burns at the Niguarda Hospital in Milan for 11 boys injured in a New Year’s Eve fire at the Le Constellation bar in Crans-Montana.
Doctors urgently requested and received 15 bottles of the enzyme-based gel from the Major Burns Center at Villa Scassi Hospital, valued at approximately 20,000 euros. The gel, developed by the Israeli company MediWound, isn’t widely available; the Genoa center is one of only eight in Italy certified by the European Burns Association for its high standards of burn care.
About the Treatment
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The medication, available in powder and gel form, is marketed in Italy by Mediwound Germany and is covered by the National Health Service. Approved for use in the European Union – including Italy – since 2012, it requires a prescription and can only be administered by trained healthcare professionals in specialized burn centers. According to a list from the AIFA (Italian Medicines Agency), marketing of the 2-gram dosage ceased in October 2025, while the 5-gram dosage faced “production problems,” prompting AIFA to authorize imports of similar drugs on November 21, 2025, a measure reserved for situations lacking viable therapeutic alternatives.
The active ingredient is bromelain, an enzyme extracted from pineapple stems. These enzymes break down complex proteins into simpler components, facilitating the removal of damaged burn tissue – known as eschar – within hours.
Why It Matters
Severe burns often result in a hard, blackened crust that, rather than shielding against bacteria, attracts them, increasing the risk of bloodstream infections and life-threatening sepsis. Rapid removal of this eschar is crucial. Traditionally, this required surgery after about a week, carrying inherent risks for patients. The gel offers a less invasive alternative: applied to the eschar for around four hours, it dissolves the dead tissue while preserving healthy skin, eliminating the need for a scalpel and shortening recovery time by days.
A Drug in Short Supply
The burn treatment gel is currently listed among Italy’s shortage drugs, according to the Italian Medicines Agency, which authorized healthcare facilities to import comparable medications in November 2025.
“Given the supply issues in Italy, AIFA has permitted centers to import this drug, but surgical and alternative pharmacological options exist,” explains Steven Paul Nisticò, a professor of Dermatology at Sapienza University of Rome and the Umberto I Polyclinic. “Surgery can remove the eschar, though it takes longer and may require anesthesia. Alternatives include drugs based on proteolytic enzymes other than bromelain, such as collagenase.”
