Objective To explore the application effect of refined suture and local flap in facial trauma repair. Methods A total of 50 patients with facial trauma admitted to Burn and Plastic Surgery Department of Danyang People's Hospital from January 2021 to January 2023 were randomly divided into control group and observation group, with 25 patients in each group. The control group was repaired by traditional suture, while the observation group was repaired by refined suture and local flap. The clinical symptoms, scar aesthetics score, scar degree score, complication rate and inflammatory factor level before and after treatment were compared between the two groups. Results The incidence of complications in the observation group was lower than that in the control group (P<0.05). After treatment, the levels of IL-1, IL-6 and TNF-α in the two groups were lower than those before treatment, and those in the observation group were lower than those in the control group (P<0.05). After treatment, the scores of VSS in the two groups were lower than those before treatment, and those in the observation group were lower than those in the control group (P<0.05). After treatment, the PSAS, OSAS and POSAS scores of the two groups were lower than those before treatment, and those in the observation group were lower than those in the control group (P<0.05). The scar length, edema duration and incision healing time in the observation group were shorter than those in the control group (P<0.05). The total effective rate of the observation group was higher than that of the control group (P<0.05). Conclusion The application of refined suture and local flap in facial trauma repair can improve the cosmetic effect and wound repair quality, reduce scar hyperplasia and inflammatory reaction, and is effective and safe.