Objective To explore the effect of target responsibility nursing on negative emotions and scar status in emergency patients with maxillofacial trauma undergoing debridement and suture. Methods A total of 60 emergency patients with maxillofacial trauma treated with debridement and suture in Liwan Central Hospital of Guangzhou from January 2024 to December 2025 were selected as the research subjects. According to different nursing schemes, they were divided into the control group and the study group, with 30 patients in each group. The control group received conventional emergency nursing, and the study group received target responsibility nursing. The nursing quality, negative emotions, quality of life, scar status and aesthetic satisfaction were compared between the two groups. Results The scores of basic nursing, nursing environment, health education, service attitude and total score in the study group after nursing were higher than those in the control group (P<0.05). The scores of HAMD and HAMA in the study group after nursing were lower than those in the control group (P<0.05). The scores of physical function, social function, psychological function and mental status in the study group after nursing were higher than those in the control group (P<0.05). The scores of POSAS and VSS in the study group were lower than those in the control group (P<0.05). The aesthetic satisfaction rate of the study group was 96.67%, which was higher than 73.33% of the control group (P<0.05). Conclusion For emergency patients with maxillofacial trauma after debridement and suture, the application of target responsibility nursing can effectively improve nursing quality, relieve negative emotions and elevate quality of life. At the same time, the nursing mode is conducive to favorable scar recovery and enhances patients' aesthetic satisfaction.