{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T11:37:56Z","timestamp":1791891476156,"version":"4.3.4"},"reference-count":42,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2024,5,11]],"date-time":"2024-05-11T00:00:00Z","timestamp":1715385600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biomimetics"],"abstract":"<jats:p>Silk and silk derivatives have emerged as a possible alternative in surgical device development, offering mechanical strength, biocompatibility, and environmental sustainability. Through a systematic review following PRISMA guidelines, this study evaluated silk fibroin\u2019s application across pre-clinical and clinical settings, focusing on its role as screws and plates for osteofixation. A comprehensive search yielded 245 studies, with 33 subjected to full-text review and 15 ultimately included for qualitative analysis. The findings underscore silk fibroin\u2019s superior properties, including its tunable degradation rates and ability to be functionalized with therapeutic agents. In vivo and in vitro studies demonstrated its efficacy in enhancing bone healing, offering improved outcomes in osteofixation, particularly for craniofacial defects. Silk fibroin\u2019s remarkable attributes in biodegradation and drug release capabilities underscore its potential to enhance patient care. Ultimately, silk fibroin\u2019s integration into surgical practices promises a revolution in patient outcomes and environmental sustainability. Its versatility, coupled with the continuous progress in fabrication techniques, signals a promising horizon for its widespread acceptance in the medical field, potentially establishing a new benchmark in surgical treatment. Further research is expected to solidify the transition of silk products from basic science to patient care, paving the way for widespread use in various surgical applications.<\/jats:p>","DOI":"10.3390\/biomimetics9050286","type":"journal-article","created":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T11:18:17Z","timestamp":1715599097000},"page":"286","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Redefining Surgical Materials: Applications of Silk Fibroin in Osteofixation and Fracture Repair"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2783-3531","authenticated-orcid":false,"given":"Jose A.","family":"Foppiani","sequence":"first","affiliation":[{"name":"Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iulianna C.","family":"Taritsa","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lacey","family":"Foster","sequence":"additional","affiliation":[{"name":"Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4014-0801","authenticated-orcid":false,"given":"Armaan","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Tufts University, Boston, MA 02155, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelica","family":"Hernandez Alvarez","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gavin J.","family":"Lin","sequence":"additional","affiliation":[{"name":"Nobles and Greenough School, Dedham, MA 02026, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodore C.","family":"Lee","sequence":"additional","affiliation":[{"name":"Georgetown University, Washington, DC 20001, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominika","family":"Gavlasova","sequence":"additional","affiliation":[{"name":"Institute of Clinical and Experimental Medicine, 140 21 Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4677-471X","authenticated-orcid":false,"given":"Maria J.","family":"Escobar-Domingo","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9245-7774","authenticated-orcid":false,"given":"David L.","family":"Kaplan","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Tufts University, Boston, MA 02155, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel J.","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e242","DOI":"10.1097\/BOT.0000000000000312","article-title":"The Epidemiology of Upper Extremity Fractures in the United States, 2009","volume":"29","author":"Karl","year":"2015","journal-title":"J. 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