Objective To analyze the improvement effect and safety of skin grafting surgery combined with scar plastic surgery on scar in burn patients. Methods A total of 86 patients with deep burn who were treated in Suqian First Hospital from January 2021 to February 2022 were selected as the research subjects, and they were randomly divided into control group and observation group, with 43 patients in each group. The control group was treated with single skin grafting surgery, and the observation group was treated with skin grafting surgery combined with scar plastic surgery. The scar condition, patient satisfaction and complication rate were compared between the two groups. Results After intervention, the scores of scar height, melanin, vascularity and pliability in the observation group were better than those in the control group, and the differences were statistically significant (P <0.05). The patient satisfaction rate in the observation group was 97.67%, which was higher than 76.74% in the control group, and the difference was statistically significant (P <0.05). The incidence of complications in the observation group was 2.33%, which was lower than 20.93% in the control group, and the difference was statistically significant (P <0.05). Conclusion The application of skin grafting surgery combined with scar plastic surgery in burn patients can effectively improve the improvement effect of scar, with higher patient satisfaction, fewer complications and higher safety, which is worthy of clinical application.