Objective To explore the application effect of refined nursing based on the concept of humanistic care during the perioperative period of skin soft tissue expansion in patients with burn scar repair. Methods A total of 78 burn scar patients who underwent skin soft tissue expansion repair treatment in our hospital from April 2020 to May 2023 were selected as the study object, and they were divided into control group andobservation group by the random number table method, with 39 patients in each group. The control group was given conventional nursing, and the observation group was given refined nursing based on the concept of humanistic care. The clinical related indexes, depression, pain level, complications and nursing satisfaction were compared between the two groups. Results The wound healing time and blood supply recovery time in the observation group were shorter than those in the control group (P <0.05). The HAMD score in the observation group after nursing was lower than that in the control group (P <0.05). The NRS score in the observation group at 24, 48 and 72 h after operation was lower than that in the control group (P <0.05). The incidence of complications in the observation group was 5.13%, which was lower than 20.51% in the control group (P <0.05). The scores of each dimension of nursing satisfaction in the observation group were higher than those in the control group (P <0.05). Conclusion The application of refined nursing based on the concept of humanistic care during the perioperative period of skin soft tissue expansion in patients with burn scar repair can effectively promote wound healing and blood supply recovery, reduce patients’ depression and pain, which is helpful to reduce the risk of complications and improve patients’ satisfaction. It is worthy of clinical application.