Objective To investigate the effect of recombinant human epidermal growth factor (rhEGF) gel combined with nano silver dressing on wound healing quality and scar formation in patients with deep second degree burns. Method: 100 patients with deep second degree burns admitted to the 71st Group Military Hospital of the Chinese People's Liberation Army from September 2022 to September 2025 were selected and randomly divided into groups of 50 each using a random number table. The control group was treated with conventional therapy combined with nano silver dressing, and the observation group was treated with rhEGF gel on the basis of the control group. Compare the wound healing effects (complete healing rate, wound area reduction rate at different time points), Vancouver Scar Scale (VSS) scores before and after treatment, and incidence of complications between two groups. After 24 weeks of treatment, the observation group had a higher complete wound healing rate than the control group (P<0.05); The wound area reduction rate in the observation group was higher than that in the control group at 2, 4, and 8 weeks after treatment (P<0.05). After 24 weeks of treatment, the VSS scores of both groups decreased compared to before treatment, and the observation group was lower than the control group (P<0.05). The total incidence of complications in the observation group was lower than that in the control group (P<0.05). Conclusion rhEGF gel combined with nano silver dressing can significantly improve the wound healing efficiency of patients with deep second degree burns, reduce the degree of scar formation, and reduce the complications during treatment. It has high clinical application value.