Objective To analyze the clinical effect of early plastic surgery in patients with hand burns. Methods A total of 60 patients with deep hand burns admitted to our hospital from June 2022 to June 2023 were selected as the research objects. According to different treatment methods, they were divided into routine group and study group, with 30 patients in each group. The conventional group was given conventional treatment, and the study group was given early plastic surgery. The clinical efficacy, hand function, daily living ability and scar outcome were compared between the two groups. Results The total effective rate of treatment in the study group was 96.67%, which was higher than 80.00% in the conventional group (P <0.05). After intervention, the scores of overall hand function, working ability, daily living ability, appearance and opponent satisfaction in the study group were higher than those in the conventional group, and the pain score was lower than that in the conventional group (P <0.05). The scores of each dimension of daily activity ability in the study group were higher than those in the conventional group (P <0.05). The scores of scar color, softness, vascular distribution and thickness in the study group were lower than those in the conventional group (P <0.05). Conclusion Early plastic surgery has a good clinical effect in the treatment of deep burn of the hand, which can improve the hand function and daily living ability of patients. It is conducive to improving the total effective rate of treatment and promoting scar recovery.