Objective To analyze the application effect of comprehensive nursing in patients with hand trauma flap transplantation. Methods From September 2022 to December 2023, 78 patients with hand trauma who underwent skin flap transplantation in Nanshu Township Center Hospital of Laixi City were selected as the research objects. They were divided into control group and observation group by random number table method, with 39 patients in each group. The control group was given routine nursing, and the observation group was given comprehensive nursing. The pain degree, flap survival rate, quality of life, living ability and hand function recovery were compared between the two groups. Results The VAS score of the observation group at 3, 5 and 7 days after nursing was lower than that of the control group (P <0.05). The total survival rate of the flap in the observation group was 97.44%, which was higher than 82.05% in the control group (P <0.05). The Barthel index score of the observation group after nursing was higher than that of the control group (P <0.05). The SF-36 score of the observation group after nursing was higher than that of the control group (P <0.05). The excellent and good rate of the observation group was 94.87%, which was higher than 79.49% of the control group (P <0.05). Conclusion For patients with hand trauma skin flap transplantation, comprehensive nursing can improve the survival rate of skin flap, reduce the pain degree of patients, improve their self-care ability and hand function, and improve the quality of life of patients.