Objective To explore the effect of random flap plasty on wound repair and scar morphology in patients with traumatic skin defects in the dermatologic surgery outpatient clinic. Methods A total of 60 patients with traumatic skin defects treated in the Dermatology Outpatient Clinic of General Hospital of Chongqing Yongrong Mining Co., Ltd from December 2024 to December 2025 were enrolled. According to different repair regimens, they were divided into the control group and the observation group, with 30 patients in each group. The control group received conventional treatment, and the observation group received random flap plasty. The wound repair, scar morphology, patient satisfaction and complication rate were compared between the two groups. Results The repair success rate of the observation group (96.67%) was higher than that of the control group (73.33%), and the wound healing time was shorter than that of the control group (P<0.05). The VSS score in the observation group was lower than that in the control group, and the patient satisfaction score was higher than that in the control group (P<0.05). The incidence of complications in the observation group (10.00%) was lower than that in the control group (30.00%) (P<0.05). Conclusion The application of random flap plasty for patients with traumatic skin defects in the outpatient clinic achieves high repair success rate. It can accelerate wound healing, improve scar morphology, reduce complications and elevate patient satisfaction, with high clinical application value.