Silk fibroin-based bioadhesives for biomedical applications.

Silk fibroin (SF) has emerged as a versatile natural protein for biomedical adhesives owing to its generally favorable biocompatibility, biodegradability, tunable mechanical properties, and abundant functional groups that enable diverse molecular engineering. Nevertheless, the intrinsically weak adhesive capability of native SF, particularly under wet physiological conditions, remains a major obstacle to its broader biomedical applications. In recent years, substantial progress has been achieved in enhancing the adhesive performance and multifunctionality of SF-based adhesives through rational molecular design and crosslinking engineering. This review systematically summarizes the latest advances in SF-based bioadhesives. First, the physicochemical characteristics, biological properties, tunability, and functionalization of SF are discussed to elucidate the molecular basis for designing high-performance adhesive systems. Subsequently, representative strategies for constructing SF-based adhesives are comprehensively reviewed, with particular emphasis on their roles in regulating interfacial adhesion, cohesive strength, mechanical properties, and biological functions. Furthermore, recent biomedical applications of SF-based adhesives are highlighted in bone tissue engineering, dental repair, wound healing, flexible skin sensors, arterial hemostasis, and deep-organ hemostasis, illustrating how rational material design enables tissue-specific adhesion and multifunctional therapeutic performance. Finally, current challenges associated with balancing adhesion strength, mechanical stability, degradation behavior, multifunctional integration, scalable manufacturing, and clinical translation are critically discussed, alongside future perspectives on biomimetic adhesive design, intelligent responsive systems, and precision regenerative medicine. By bridging molecular properties, adhesive mechanisms, construction strategies, and biomedical functions, this review provides a comprehensive understanding of SF-based bioadhesives and offers valuable guidance for the rational design and clinical translation of next-generation bioinspired adhesive materials.