**** Objective: To investigate the efficacy of combined skin grafting and skin soft tissue expansion in burn plastic surgery. Methods: A total of 80 patients undergoing burn plastic surgery (February 2021 to February 2026) were enrolled and randomly divided into groups using a random number table. The control group received only combined skin grafting, while the observation group underwent combined skin grafting plus skin soft tissue expansion. The therapeutic outcomes were compared between the two groups. Results: The observation group exhibited a higher treatment efficacy rate than the control group, with shorter wound healing and blood supply recovery times, as well as lower VAS scores (P < 0.05). Postoperative quality of life scores were higher in the observation group, while scar scores were lower compared to the control group. Inflammatory factor levels and postoperative complication rates were also significantly lower in the observation group (P < 0.05). Conclusion: The application of combined skin grafting and skin soft tissue expansion in burn plastic surgery further optimizes therapeutic outcomes, demonstrating superior efficacy compared to standalone combined skin grafting. This approach effectively alleviates postoperative pain, reduces inflammation, minimizes complications, inhibits scarring, promotes wound and blood supply recovery, and improves patients" quality of life, making it worthy of widespread adoption.