There are a variety of surgical options for syndactyly, the goal of which is to minimize the chance of a skin graft, or no skin graft at all. However, in most cases it is difficult to avoid skin grafting altogether with a syndactyly split toe surgery because he doesn’t have enough skin, and why wouldn’t he have enough skin? Because when the toes that are joined together are separated there is a deficit in the amount of skin on the opposite edges of the toe purses. How to deal with the missing part between the toes? 1, skin grafting, with other parts of the body skin to cover the wound; 2, do flap transfer, including the proximal skin, lateral skin, do a flap transposition to cover the defective area. These two methods have their own characteristics and indications. Comparatively speaking, if there is no bone exposure after toe splitting, skin grafting can basically solve all the traumatic problems. However, skin grafting has its inherent complications. The donor area for skin grafting is usually chosen from the child’s abdomen because the skin here is more pliable and resilient, which is more suitable. However, removing the skin from the abdomen will result in additional trauma and scarring, which will affect the child’s ability to dress in the future. Then in the recipient area will also have a certain impact, there will be certain problems: 1, skin grafting is not 100% can survive, it has a certain chance of survival failure, this chance is not high, but also exists. If the implant necrosis surgery is equivalent to do in vain, need to change the medicine, and then again implanted skin; 2, implanted skin in the appearance of the recipient area and the original skin will look different, the color will be darker, the phenomenon of hyperpigmentation, sensory function will also have a certain decline. The advantage of skin grafting is that it heals faster and the recovery period is shorter. If the syndesmosis and splitting of the toes occurs in a situation where the bone is exposed and a skin graft is not possible, a skin flap can be used to repair the splitting of the toes. It avoids the need for a skin graft and does not require new trauma to other parts of the body. However, if there is also a skin defect at the distal end of the toe body, a skin graft will still be used. In order to solve these problems, we now use artificial dermis-induced skin graft-free technique to do the syndesmosis surgery, which uses artificial dermis material to induce skin growth directly, without additional trauma from other parts of the body, completely avoiding the possibility of skin grafting. The new skin induced by artificial dermis will be very similar to the original one, and there will be no hyperpigmentation or decrease in sensory function, so the overall effect is relatively good.