Objective To analyze the effect of abdominal vascular pedicle skin flap repair for the treatment of skin defects in patients with hand trauma. Methods A total of 100 patients with hand trauma admitted to our hospital from January 2019 to January 2023 were selected as the research subjects. All patients underwent abdominal vascular pedicle skin flap repair, and were grouped according to the treatment effect. Relevant risk factors affecting the therapeutic effect were analyzed. Results Among the 100 cases of hand injury patients with skin defects, 89.00% had an ideal therapeutic effect, which was higher than the 11.00% with poor therapeutic effect (P<0.05). There was no statistically significant difference in the cause and age of hand trauma between patients with ideal therapeutic effect and those with poor therapeutic effect (P>0.05). There were statistically significant differences between the patients with ideal therapeutic effect and those with poor therapeutic effect in terms of injured limbs, complications, injured area of hand trauma, and time from injury to treatment (P<0.05). The affected limb of hand trauma, complications, damaged area of hand trauma, and time from injury to treatment were the main risk factors affecting the treatment effect of skin defect in patients with hand trauma (P<0.05). Conclusion Hand trauma is more common in clinical practice. Abdominal vascular pedicle flap repair is more effective in the treatment of skin defects. However, the right side of the injured limb, postoperative complications, excessive damage area of hand trauma, and long time from injury to treatment can reduce the therapeutic effect. It is necessary to improve the degree of attention and do a good job in relevant intervention strategies to achieve the purpose of improving the therapeutic effect.