Objective To analyze the application effect of comprehensive nursing in patients with scar after burn repair by skin soft tissue expansion. Methods A total of 50 patients with with scar after burn admitted to Guizhou Provincial People's Hospital from January 2021 to December 2022 were selected and divided into control group and observation group according to the random number table method, with 25 patients in each group. All patients received skin and soft tissue expansion. On this basis, the control group received routine nursing, and the observation group received comprehensive nursing. The scar condition, nursing effect, postoperative appearance and function satisfaction, sleep quality (PSQI) score and complications were compared between the two groups. Results The VSS score of the observation group was lower than that of the control group after nursing (P <0.05). The total effective rate of nursing in the observation group was higher than that in the control group (P <0.05). The postoperative appearance and function satisfaction of the observation group was higher than that of the control group (P <0.05). The PSQI score of the observation group was lower than that of the control group after nursing (P <0.05). The incidence of complications in the observation group was lower than that in the control group (P <0.05). Conclusion For patients with skin and soft tissue expansion to repair scars after burns, comprehensive nursing can effectively improve their scar conditions, improve postoperative appearance and functional satisfaction, sleep quality, and reduce the risk of complications.