Objective To analyze the effect of skin soft tissue expansion in burn and plastic surgery. Methods A total of 50 patients with burn and plastic surgery admitted to our hospital from January 2019 to December 2023 were selected as the research objects. They were divided into control group and experimental group by random number table method, with 25 patients in each group. The control group was treated with composite skin transplantation, and the experimental group was treated with skin soft tissue expansion. The clinical efficacy, clinical related indicators, quality of life, negative emotions and complications were compared between the two groups. Results The total effective rate of treatment in the experimental group was 96.00%, which was higher than 64.00% in the control group (P <0.05). The healing time, blood supply recovery and VAS scores of the experimental group were better than those of the control group (P <0.05). The scores of physiological function, mental health, physical pain and social function in the experimental group were higher than those in the control group (P <0.05). The scores of SAS and SDS in the experimental group were lower than those in the control group (P <0.05). The incidence of complications in the experimental group was lower than that in the control group (P <0.05). Conclusion Skin soft tissue expansion can improve the symptoms of patients with burn and plastic surgery, relieve their negative emotions, and improve the quality of life. It is a safe and effective treatment.