Objective To explore the application effect of skin wound tension reduction device combined with LBD suture technique in patients with keloid. Methods A total of 100 patients with keloid admitted to our hospital from January 2021 to February 2022 were randomly divided into control group and observation group, with 50 patients in each group. The control group was treated with surgical resection combined with LBD suture technique and shallow radiotherapy, and the observation group was treated with skin wound tension reduction device combined with LBD suture technique. The clinical efficacy, scar score and scar width were compared between the two groups. Results The total effective rate of treatment in the observation group was 98.00%, which was higher than 74.00% in the control group (P <0.05). The VSS score of the observation group was lower than that of the control group at 3, 6, 12 and 24 months after operation (P <0.05). The scar width of the observation group was smaller than that of the control group at 3, 6, 12 and 24 months after operation (P <0.05). Conclusion Skin wound tension reduction device combined with LBD suture technique is effective in the treatment of keloid, which can improve the total effective rate of treatment, effectively reduce the degree of scar hyperplasia, reduce the width of scar, and is worthy of clinical application.