Objective To analyze the efficacy of bilayer artificial dermis combined with autologous scar epidermis graft in the treatment of post-burn scar contracture of hands and feet and its inffuence on immune function and inffammatory factor levels. Methods A total of 86 patients with post-burn scar contracture of hands and feet admitted to the Department of Burn and Plastic Surgery, the Fifth Hospital of Baoding from May 2023 to May 2025 were selected as the research subjects. According to the admission order, they were divided into the control group and the study group, with 43 patients in each group. The control group received autologous intermediate-thickness skin grafting, and the study group received bilayer artificial dermis combined with autologous scar epidermis grafting. The repair effect, immune function and inflammatory factor levels were compared between the two groups. Results After operation, the scores of all dimensions of VSS and total score in the study group were lower than those in the control group (P<0.05). At 7 days after operation, the levels of IgA, IgG, IgM, IL-2 and IFN-γ were higher than those in the control group, and the level of IL-6 was lower than that in the control group (P<0.05). Conclusion Bilayer artificial dermis combined with autologous scar epidermis graft has a definite effect in repairing post-burn scar contracture of hands and feet, and can simultaneously regulate immune and inffammatory responses, which is worthy of clinical application.