Objective To explore the clinical effect of predictive nursing for patients with traumatic wounds repaired by free flaps. Methods A total of 60 patients with traumatic wounds repaired by free flaps admitted to the People's Hospital of Linxia from February 2020 to April 2022 were selected as the research objects. They were divided into reference group and study group by random number table method, with 30 patients in each group. The reference group was given routine nursing, and the study group was given predictive nursing. The incidence of vascular crisis, surgical success rate, flap necrosis rate, flap color, flap temperature, flap texture score and pain score were compared between the two groups. Results There was no significant difference in the success rate of operation between the two groups (P>0.05). The incidence of vascular crisis and skin flap necrosis rate in the study group were lower than those in the reference group, the differences were statistically significant (P