Introduction: Burns in specialised areas including the face, hand and flexural creases remain a complex reconstructive challenge. The ideal of restoring both form and function remains limited with conventional skin grafting techniques due to scar contracture and poor cosmesis. Often reserved for facial burn reconstruction, use of the dermal substitute Matriderm, in combination with skin grafting has shown promising results in our recent series of patients. Methods: We describe 3 patients who underwent both acute and chronic burn wound reconstruction utilising Matriderm acellular dermal matrix in several specialised areas including the axilla, hand and knee. Patients with acute burn wounds underwent conventional early burn wound debridement and reconstruction with Matriderm acellular dermal matrix covered with sheet split thickness skin grafts (STSG) abiding to aesthetic subunits. Chronic burn patients underwent similar delayed debridement and one-stage reconstruction with Matriderm and sheet STSG. Results: Graft take on Day 7 review was 100%. Early 3-month graft follow-up demonstrated excellent aesthetic results in measurements of both texture and colour. Chronic burn wound reconstruction patients demonstrated significant improvement in overall function following complete resurfacing of their burn scar contracture. Conclusion: The use of Matriderm for one-stage reconstruction of complex burn wounds has demonstrated promising results in our case series of patients, both in terms of aesthetic and functional outcomes on early follow-up.