Objective To analyze the effect of Situation-Background-Assessment-Recommendation (SBAR) communication mode on scar improvement and exercise compliance in patients undergoing free ffap transplantation for hand trauma. Methods A total of 80 patients undergoing free ffap transplantation for hand trauma admitted to General Hospital of Ningxia Medical University from January to December 2025 were selected, and they were divided into the reference group (40 patients) and the observation group (40 patients) by the random number table method. The reference group received conventional nursing, and the observation group received SBAR communication mode on the basis of the reference group. The scar improvement, postoperative pain relief, exercise compliance, hand function recovery, quality of life and complication rate were compared between the two groups. Results After intervention, the scores of VSS and VAS in the observation group were lower than those in the reference group (P<0.05). The exercise compliance rate of the observation group was higher than that of the reference group (P<0.05). After intervention, the scores of Carroll and SF-36 in the observation group were higher than those in the reference group (P<0.05). The incidence of complications in the observation group (2.50%) was lower than that in the reference group (15.00%) (P<0.05). Conclusion The application of the SBAR communication mode based on conventional nursing can effectively improve scar severity in patients undergoing free ffap transplantation for hand trauma, reduce postoperative pain, increase exercise compliance, promote the recovery of hand function, and enhance quality of life.