Objective To explore the effect of artificial dermis grafting combined with fractional autologous micro-skin column grafting in patients with deep wounds. Methods A total of 30 patients with deep second-degree or above wounds or full-thickness skin defect wounds admitted to Dongguan Houjie Hospital from May 2022 to February 2025 were selected, and they were divided into the control group and the observation group according to different skin grafting techniques, with 15 patients in each group. The control group was treated with micro-skin grafting technology, and the observation group was treated with artificial dermis grafting combined with fractional autologous micro-skin column grafting. The recovery status, skin graft survival rate and scar status were compared between the two groups. Results The total wound healing time and joint function recovery time of the observation group were shorter than those of the control group (P <0.05). The skin graft survival rate of the observation group was (90.05±9.12)%, which was higher than (82.63±8.35)% of the control group (P <0.05). The VSS scores of the observation group at 1, 3 and 6 months after operation were lower than those of the control group (P <0.05). Conclusion Artificial dermis grafting combined with fractional autologous micro-skin column grafting can improve the skin graft survival rate, help to accelerate the healing of deep wounds and optimize scar status.