To analyze the effect of family collaborative nursing on wound healing and scar aesthetics in patients undergoing mastectomy. Methods Sixty patients with mastectomy who were treated in our hospital from July 2022 to September 2023 were selected as the research objects. They were divided into control group and observation group by random number table method, with 30 patients in each group. The control group was given perioperative nursing, and the observation group was given family collaborative nursing on the basis of the control group. The wound healing, scar desalination, anxiety and depression were compared between the two groups. Results The healing rate of grade A wound in the observation group was higher than that in the control group (P <0.05). The scores of OSAS and PSAS in the observation group were lower than those in the control group (P <0.05). The SAS and SDS scores of the observation group were lower than those of the control group (P <0.05). Conclusion For patients with mastectomy, family collaborative nursing intervention can optimize the degree of wound healing, dilute the wound scar, and promote the improvement of their psychological state.