Unraveling the roles of fibrous silk in biomedical applications: A review

Biomedical materials have become essential for diagnosing, treating, and repairing diseased tissues, with applications ranging from hard dental implants to soft artificial blood vessels. Among these, fibrous silk (FS) – a naturally assembled material with exceptional mechanical and biological properties – has recently emerged as a promising candidate for advancing biomedical technologies, particularly with the advent of additive manufacturing and three-dimensional (3D) printing. This review comprehensively explores the advancements in FS-based materials for biomedical applications over the past two decades (2004 – 2024). FS, a unique material derived from silkworm silk fibers, exhibits exceptional mechanical properties, biocompatibility, controlled biodegradability, and antimicrobial characteristics, positioning it as a versatile candidate for various biomedical applications. The review begins with a detailed analysis of FS structure and morphology, covering natural FS, derived FS, and assembled FS. It then delves into the critical properties relevant to biomedical applications, such as mechanical resilience, biointegration, controlled degradation profiles, and antimicrobial performance. Subsequently, the review examines the extensive applications of FS-based materials across various biomedical fields, particularly in tissue engineering and regenerative medicine. Special emphasis is placed on the role of additive manufacturing and 3D printing in enhancing the design complexity and functional performance of FS-based scaffolds, highlighting their potential for developing customized implants and tissue-engineered constructs. Finally, the review provides insights into the future potential of FS-based materials, addressing current limitations and proposing strategies to further optimize their functionality in biomedical contexts.