Objective To explore the clinical efficacy and safety of microsurgery in hand retrograde skin avulsion.Methods 56 patients with hand retrograde skin avulsion were selected and randomly divided into study group(28 cases)and control group(28 cases).The study group was taken treatment of microsurgery,the control group was taken treatment of free return FLAP treatment plant.The treatment effect of the two groups was compared. Results The total effective rate of the study group was 96.4%,which was significantly higher than 78.6% of the control group(χ2 =4.082,P =0.043).The average survival skin rate of the study group was (95.62 ±4.23)%, which was significantly higher than (73.20 ±6.48)% of the control group(t =15.331,P =0.000).The skin index in the study group was significantly better than the control group (χ2 =4.909,P =0.027).Conclusion Hand retrograde skin avulsion in patients using microsurgical treatment method can maximize recovery skin vitality and improve the appearance and function of the hand of patients,and improve the therapeutic effect.