Alloderm as a biomechanical scaffold in situations such as skin grafting has been previously demonstrated. In this paper we describe its utility in a broad range of post-traumatic and congenital hand defects. During the recent three years, 11 patients (7 male, 4 female) ranging in age from 8 to 84 years underwent hand resurfacing using acellular dermis graft. There were 10 traumatic and 1 congenital hand deformities (constriction ring syndrome). The acellular dermis was used as both a dermal filler and as a spacer construct. There was no obvious loss of the acellular dermis or infection. Stable resurfacing was achieved in all patients with reasonable functional and cosmetic outcomes.