Introduction: To complement the drawbacks of skin grafts, dermal substitutes such as acellular dermis or artificial dermal matrix, such as Matriderm can be applied.[1] Case: 41-year-old male presented with crush injury to his left hand following a road buggy rolled onto his hand, examination shows potential skin loss on the dorsal aspect of his hand. X-ray showed a fracture at the 2nd metacarpal of the left hand. His left hand was debrided and conservative management of fracture. At 7 days postoperatively, it was noticed that his skin loss had established itself and there was at least 5cm by 3cm full-thickness skin loss. His left hand was further debrided and reconstructed with Matriderm application and split-thickness skin graft. His graft is taken one week post operation. At 5 months post-operative follow-up, he has good progress with hand therapy. He was able to make a full fist without any signs of tethering to the wound. He indicated that he had regained his full function and was satisfied with the result. Discussion: Using Matriderm allows the procedure with skin graft to be done in one stage in a full-thickness defect. It also helps to avoid excessive scarring and wound contraction.[2] Conclusion: Matriderm with split-thickness skin graft is a promising option for dorsal hand full-thickness defect for crush injury. References: 1.Min, J. H., Yun, I. S., Lew, D. H., Roh, T. S., & Lee, W. J. (2014). The Use of Matriderm and Autologous Skin Graft in the Treatment of Full Thickness Skin Defects. Archives of Plastic Surgery, 41(4), 330–336. https://doi.org/10.5999/aps.2014.41.4.330 2.Cervelli, V., Lucarini, L., Cerretani, C., Spallone, D., Palla, L., Brinci, L., & De Angelis, B. (2010). The use of Matriderm® and autologous skin grafting in the treatment of diabetic ulcers: a case report. International Wound Journal, 7(4), 291–296. https://doi.org/10.1111/j.1742-481X.2010.00687.x