Abstract： AIM: To reduce the antigen of heterogeneous/allogeneic dermis and to promote the application of composite skin(CS) graft on extensive burn.METHODS: 18 acellular dermal matrixes(ADM) cross linked by glutaraldehyde taken from human(h-CS) and 8 acellular dermal sheets taken from swine(s-CS) combined with thin split-thickness autograft were grafted on 13 wounds of escharectomy, while autograft of epidermis was used as control. The change of tissue structure, survival rate of skin graft and its appearance were observed.RESULTS: There were thin sheets of basal membrane on the surface of ADM, and fibroblasts as well as endothelial cells disappeared. No significant difference of survival rate was found among different groups. The CS appeared smooth without observable immunologic rejection and hypertrophic scarring. Only 5 grafts failed to survive in CS group and the reason for the failure might be the overthickness of ADM (>0.3 mm) and glutaraldehyde remaining in the tissue.CONCLUSION: ADM, particularly the P-ADM allograft, is convenient and effective for the management of extensive burn by CS grafting. In view of some of the disadvantages such as the occupancy on the wound, the manufacture method should be further improved.