To explore the application effect of perioperative high quality nursing in patients with severe limb soft tissue defect repaired by pedicle perforator flap transplantation. Methods From October 2022 to October 2023, 90 patients with severe soft tissue defects of extremities treated by pedicle perforator flap transplantation in the 901st Hospital of the Joint Logistics Support Force of the People's Liberation Army of Chinese were selected as the research objects. They were divided into control group and experimental group by random number table method, with 45 patients in each group. The control group was given routine nursing, and the experimental group was given perioperative high quality nursing. The nursing effect, satisfaction and complications of the two groups were compared. Results The total effective rate of nursing in the experimental group was 95.56%, which was higher than 77.78% in the control group, the difference was statistically significant (P <0.05). The nursing satisfaction of the experimental group was 97.78%, which was higher than 84.44% of the control group, and the difference was statistically significant (P <0.05). The total incidence of complications in the experimental group was 4.44%, which was lower than 17.78% in the control group, the difference was statistically significant (P <0.05). Conclusion The effect of perioperative high quality nursing on patients with severe limb soft tissue defect repaired by pedicle perforator skin valve is better, which can improve nursing satisfaction and reduce the incidence of complications. It is worthy of clinical application.