Silk fibroin has applications in different medical fields such as tissue engineering, regenerative medicine, drug delivery and medical devices. Advances in silk chemistry and biomaterial designs have yielded exciting tools for generating new silk-based materials and technologies. Selective chemistries can enhance or tune the features of silk, such as mechanics, biodegradability, processability and biological interactions, to address challenges in medically relevant materials (hydrogels, films, sponges and fibres). This Review details the design and utility of silk biomaterials for different applications, with particular focus on chemistry. This Review consists of three segments: silk protein fundamentals, silk chemistries and functionalization mechanisms. This is followed by a description of different crosslinking chemistries facilitating network formation, including the formation of composite biomaterials. Utility in the fields of tissue engineering, drug delivery, 3D printing, cell coatings, microfluidics and biosensors are highlighted. Looking to the future, we discuss silk biomaterial design strategies to continue to improve medical outcomes.

丝素蛋白在组织工程、再生医学、药物输送和医疗器械等不同医学领域都有应用。丝绸化学和生物材料设计的进步已经产生了令人兴奋的工具，用于生成新的丝绸材料和技术。选择性化学可以增强或调整丝绸的特性，例如力学、生物降解性、加工性和生物相互作用，以应对医学相关材料（水凝胶、薄膜、海绵和纤维）中的挑战。本综述详细介绍了丝生物材料在不同应用中的设计和实用性，尤其侧重于化学。本综述包括三个部分：丝蛋白基础知识、丝化学和功能化机制。接下来是对促进网络形成的不同交联化学的描述，包括复合生物材料的形成。突出了组织工程、药物输送、3D 打印、细胞涂层、微流体和生物传感器领域的实用性。展望未来，我们讨论丝绸生物材料设计策略，以继续改善医疗效果。