Objective To investigate the effect of recombinant human epidermal growth factor (rhEGF) gel combined with nano-silver dressing on wound healing effect and scar formation in patients with deep second-degree burns. Methods A total of 100 patients with deep second-degree burns admitted to Army 71st Group Military Hospital from June 2022 to June 2025 were selected, and they were divided into group A and group B by the random number table method, with 50 patients in each group. Group A received conventional therapy combined with nano-silver dressing, and group B was additionally treated with rhEGF gel on the basis of group A. The wound healing effect, scar formation and complications were compared between the two groups. Results At 24 weeks after treatment, the complete wound healing rate of group B was 94.00%, which was higher than 78.00% of group A (P<0.05). The wound area reduction rates of group B at 2, 4 and 8 weeks after treatment were all higher than those of group A (P<0.05). At 24 weeks after treatment, the scores of VSS in the two groups were lower than those before treatment, and those in group B were lower than those in group A (P<0.05). The incidence of complications in group B was lower than that in group A (P<0.05). Conclusion rhEGF gel combined with nano-silver dressing in the treatment of deep second-degree burns can effectively improve wound healing effect, alleviate scar formation, and reduce the complications.