Objective To study the effect of refined cosmetic nursing after plastic skin grafting in burn patients and its effect on wound healing. Methods A total of 76 burn patients who underwent plastic skin grafting in our hospital from February 2023 to February 2024 were randomly divided into control group and observation group, with 38 cases in each group. The control group was given routine nursing, and the observation group was given refined beauty nursing. The treatment time index, pain degree, sleep quality, bad mood, satisfaction and complications were compared between the two groups. Results The growth granulation time, wound healing time and hospitalization time of the observation group were shorter than those of the control group (P <0.05). The VAS score of the observation group after nursing was lower than that of the control group (P <0.05). The PSQI score of the observation group after nursing was lower than that of the control group (P <0.05). After nursing, the SAS and SDS scores of the observation group were lower than those of the control group (P <0.05). The satisfaction rate of the observation group was 94.74%, which was higher than 71.05% of the control group (P <0.05). The incidence of complications in the observation group was 7.89%, which was lower than 28.95% in the control group (P <0.05). Conclusion The application of refined cosmetic nursing in burn patients after plastic skin grafting is effective, which can accelerate the wound healing rate and prevent related complications. At the same time, it can help patients reduce pain, improve bad mood and sleep quality, and improve patient satisfaction.