Objective To explore the effect of skin grafting combined with scar plastic surgery in burn patients. Methods A total of 60 burn patients admitted to the Department of Burn and Plastic Surgery, Huaiji County People's Hospital from January 2023 to May 2024 were selected as the research objects. According to different intervention methods, they were divided into conventional group and experimental group, with 30 patients in each group. The conventional group was treated with skin grafting, and the experimental group was treated with skin grafting combined with scar plastic surgery. The scar condition, scar hyperplasia, psychological state and wound healing were compared between the two groups. Results After treatment, the scores of thickness, color, vascular distribution and softness in the two groups were lower than those before treatment, and those in the experimental group were lower than those in the conventional group (P <0.05). The scar hyperplasia rate of the experimental group was 70.00%, which was lower than 93.33% of the conventional group (P <0.05). The HAMA and HAMD scores of the two groups after treatment were lower than those before treatment, and those of the experimental group was lower than those of the conventional group (P <0.05). The number of subcutaneous hematoma and wound healing time in the experimental group were better than those in the conventional group (P <0.05). Conclusion The application of skin grafting combined with scar plastic surgery in burn patients is effective, which can effectively improve the scar condition and reduce the scar hyperplasia rate. It has a positive effect on promoting wound healing and alleviating the negative emotions of patients. It is worthy of clinical application.