Background: Despite cocoon silk’s well-known strength, biocompatibility, and hypoallergenic properties, its potential medical applications remain largely unexplored. This review, therefore, is of significance as it evaluates the mechanical properties and clinical potential of cocoon silk, a material with promising applications in biomaterials and tissue engineering. Methods: We conducted a comprehensive systematic review adhering to PRISMA guidelines. Our focus was on the primary outcomes of tensile strength and elongation at break, and the secondary outcomes included other mechanical properties, applications, and complications. Results: Out of the 192 silk-related studies, 9 met the criteria. These studies revealed that cocoon silk derivatives exhibit a wide range of tensile strength, from 0.464 to 483.9 MPa (with a median of 4.27 MPa), and elongation at break, from 2.56% to 946.5% (with a median of 60.0%). Biomedical applications of cocoon silk derivatives span from tissue regeneration (n = 6) to energy harvesting (n = 4). Complications often arose from material fragility in non-optimized derivative components. Conclusions: While cocoon silk shows expansive promise due to its suitable mechanical properties and low complication risk, plenty remains to be discovered. Future research is crucial to fully realizing its vast surgical and biomedical potential.

Introduction: Facial artery pseudoaneurysm is a rare but serious condition that can develop after traumatic or iatrogenic injury. If undetected or untreated, it risks rupture, massive bleeding, and damage to nearby structures, potentially leading to life-threatening complications. Prompt diagnosis and treatment are essential to prevent these risks, with options including surgical repair or endovascular embolization. Methods: This systematic review followed PRISMA guidelines and conducted comprehensive searches of MEDLINE, Embase, Web of Science, Cochrane Central, and ClinicalTrials.gov for studies published through 2025, supplemented by manual citation searches. Extracted data included patient demographics, diagnostic approaches, management, and outcomes. Quality was assessed using the National Institutes of Health Quality Assessment tool. Findings were descriptively analyzed. Results: During study selection, 452 studies were identified; 383 were screened, yielding 36 patient case reports of facial artery pseudoaneurysms. The mean patient age was 31 years, and 78% were male. Etiologies were primarily iatrogenic injury (49%) or traumatic injury (46%), with an average presentation time of 21 days. The most common site for pseudoaneurysm development was the submandibular region (30%). Management included open surgical repair (35%) or endovascular embolization (57%), with a recurrence rate of 8%. Conclusions: Facial artery pseudoaneurysms are rare, usually resulting from traumatic or iatrogenic injury, and typically present within 21 days. Most are effectively treated with open surgical repair or endovascular embolization, with low recurrence and complication rates. Prompt diagnosis and management are crucial to preventing serious outcomes.

Background: In maxillofacial reconstruction, even small inaccuracies can compromise aesthetics, function, and safety. Surgeons currently rely on preoperative imaging; however, recent advances in intraoperative imaging now provide three-dimensional, real-time guidance, possibly enhancing surgical outcomes. This review evaluates the current application of intraoperative imaging in maxillary and mandibular surgery including its impact on accuracy, efficiency, and outcomes. Methods: Two separate systematic reviews (PROSPERO CRD420251125497, CRD420251124600), analyzing maxillary and mandibular repair were conducted through Cochrane, Medline, Embase, and Web of Science. Both reviews adhered to the PRISMA guidelines. Inclusion criteria encompassed intraoperative digital imaging or navigation in maxillary or mandibular surgery. Studies without human subjects, intraoperative imaging, or the surgery of interest were excluded. Bias was assessed with NIH Quality Assessment. Results: A combined total of 795 publications were screened, with 35 studies ultimately included in this review, encompassing 1643 patients. Techniques included intraoperative computed tomography (CT) (n = 12, 34.3%), stereotactic navigation (n = 16, 45.7%), augmented reality (n = 2, 5.7%), ultrasound, fluoroscopy, infrared stereoscopic and electromagnetic (n = 1, 2.9%, each). The most common indication for surgery was fracture repair. Reporting was heterogeneous, with variable metrics and reporting for accuracy, complications, and revisions. Overall, cone-beam CT (CBCT) and stereotactic navigation both demonstrated significant restoration of normal symmetry, and stereotactic navigation enabled accuracy of <2 mm. CBCT added the shortest amount of time intraoperatively, ranging from 1 to 20 min. Reporting on long-term outcomes was heterogeneous. Conclusions: A variety of intraoperative imaging and navigation techniques are being applied in maxillofacial surgery. However, inconsistent reporting metrics, small study size, and study feasibility-focused study design limit meaningful comparison across technologies. Rigorous prospective studies with standardized outcome measures are needed to further define their clinical value and guide adoption.

Background: Nerve conduits are used to bridge peripheral nerve defects caused by trauma, iatrogenic injury, or oncologic disruption. Three-dimensional (3D) biomimetic scaffolds for peripheral nerve regeneration have advanced significantly in recent years, driven by improvements in printing technology and neuronal seeding techniques. We report on published designer conduits that can recreate the epineurium, a critical yet challenging-to-manufacture feature of nerve tissue. Methods: A medical librarian conducted a literature search for our systematic review on EMBASE, Web of Science, and PUBMED, following PRISMA guidelines, for articles from January 2010 to January 2026 for the systematic review. Descriptive statistical analysis was performed using Microsoft 365 Suite software. The literature review was conducted using keywords and search terms describing the history and development of 3DP nerve guidance conduits published prior to January 2026. Results: Our search yielded 273 titles, of which 8 were included after full-text review; these studies used 3D printing to generate nerve conduits for preclinical models. Manual data extraction identified studies reporting successful epineurial recreation. The included scaffold materials were polycaprolactone, poly(l-lactide-co-ε-caprolactone), poly(lactic-co-glycolic acid), acrylate resin, and gelatin methacryloyl. In animal model studies, various terms were used to describe the epineurium outer sheath. Despite this variability in nomenclature, many of these reports indicated successful sciatic functional index (SFI) recovery, favorable g-ratios, good durability, high cell viability, and significant neurite elongation at the time of sacrifice. Conclusions: 3DP nerve conduits targeting the epineurium are promising approaches for treating peripheral nerve defects. The constructs promote oriented growth and myelination. Future research on incorporating the epineurium into nerve scaffolds may consider encapsulating NGF to promote more efficient nerve regeneration, standardizing the definition of epineurial recreation, designing mechanical and permeability reporting benchmarks, and evaluating cell strategies using comparable functional and histologic endpoints.