Objective To investigate the clinical effect of inguinal flap repair in the treatment of hand and forearm skin burn scar. Methods From January 2020 to December 2021,100 patients with hand and forearm skin burn scars admitted to the Department of Burns and Plastic Surgery of Handan Hangang Hospital were selected as the research objects. According to the random number table method, they were divided into observation group and control group, with 50 cases in each group. The control group was treated with anterolateral thigh flap repair, and the observation group was treated with inguinal flap repair. The time of pedicle division, flap survival, flap infection, clinical efficacy, inflammation around the wound and recovery of burn tissue were compared between the two groups. Results The flap survival rate, flap pedicle cutting time and flap infection rate in the observation group were better than those in the control group (P<0.05). The total effective rate of treatment in the observation group was 96.00%, which was higher than 80.00% in the control group (P<0.05). The scores of inflammation around the wound in the observation group were higher than those in the control group at 2, 3, 4 and 5 weeks after treatment (P<0.05). After treatment, the scores of limb function recovery and skin repair in the two groups were higher than those before treatment, and those in the observation group were higher than those in the control group (P<0.05). Conclusion The clinical effect of inguinal flap repair in the treatment of hand and forearm skin burn scar is definite, which can effectively improve the survival rate of flap, control the inflammatory reaction around the wound, reduce the incidence of flap infection, so as to improve the limb function and skin condition, and promote the rapid recovery of patients.