Objective To investigate the effect of artiffcial dermis combined with autologous split-thickness skin grafting on graft survival in patients with burn contracture scars. Methods A total of 48 patients with burn contracture scars admitted to our hospital from January 2021 to December 2023 were selected. According to the random number table method, they were divided into group A and group B, with 24 patients in each group. Group A received autologous intermediate-thickness skin grafting, and group B received artiffcial dermis combined with autologous split-thickness skin grafting. The graft survival, wound healing, scar condition and functional recovery of the recipient site were compared between the two groups. Results The excellent and good rate of graft survival in group B was 87.50%, compared with 83.33% in group A, the difference was not statistically signiffcant (P>0.05). The complete healing time of the recipient site in group B was longer than that in group A, while the complete healing time of the donor site was shorter than that in group A (P<0.05). There was no statistically signiffcant difference in VSS score of the recipient site at 12 months after surgery between the two groups (P>0.05). The VSS score of the donor site in group B at 12 months after surgery was lower than that in group A (P<0.05). The ADL score of the recipient site at 12 months after surgery in the two groups was higher than that before surgery (P<0.05), and there was no statistically signiffcant difference between the two groups (P>0.05). Conclusion Artiffcial dermis combined with autologous split-thickness skin grafting for burn contracture scars can achieve similar graft survival, appearance and function as autologous intermediate-thickness skin grafting. Meanwhile, itcan reduce donor site injury, shorten healing time, and effectively solve the problem of insufffcient skin source for late scar plastic surgery in burn patients.