Objective To analyze the effect of acellular dermal matrix (ADM) combined with autologous split-thickness skin graft on wound recovery and scar formation in patients with burn scar repair. Methods By using the random number table method, 86 patients with burn scar repair admitted to Jinan Hospital of Integrated Traditional Chinese and Western Medicine from February 2023 to February 2025 were divided into the control group (43 patients) and the observation group (43 patients). The control group was treated with autologous split-thickness skin graft, and the observation group was treated with ADM combined with autologous split-thickness skin graft. The wound recovery, scar formation, serum-related indicators and complications were compared between the two groups. Results The wound healing rate and graft survival rate in the observation group at 2 weeks after operation were higher than those in the control group [(94.58±1.63)% vs (90.21±1.20)%, 97.67% vs 81.40%], and the wound healing time was shorter than that in the control group (P <0.05). The scores of color, softness, pain, scar thickness, vascular distribution and pruritus in the observation group were lower than those in the control group (P <0.05). The levels of VEGF and TGF-β in the observation group after operation were higher than those in the control group(P <0.05). No statistically significant difference was observed in complication rates between the observation and control groups (P >0.05). Conclusion ADM combined with autologous splitthickness skin graft can accelerate wound healing in patients with burn scar repair, promote scar regression, increase serum growth factor levels, and have high safety.