Objective To explore the effect of refined nursing intervention in operating room on postoperative complications of patients undergoing auricular reconstruction. Methods A total of 94 patients who underwent auricular reconstruction in our hospital from August 2023 to August 2024 were selected as the research subjects. According to the random number table method, they were divided into the routine group and the experimental group, with 47 patients in each group. The routine group received routine nursing intervention, and the experimental group received refined nursing intervention in operating room. The emotional state, postoperative complications, surgical efficiency related indicators, nursing quality and nursing satisfaction were compared between the two groups. Results After intervention, the scores of SDS and SAS in the experimental group were lower than those in the routine group, and the differences were statistically significant (P <0.05). The incidence of complications in the experimental group was 2.13%, which was lower than 14.89% in the routine group, and the difference was statistically significant (P <0.05). The operation preparation time, transfer time and operation time in the experimental group were shorter than those in the routine group, and the differences were statistically significant (P <0.05). The scores of hygiene disinfection, nursing records, nursing professional qualities and item management quality in the experimental group were higher than those in the routine group, and the differences were statistically significant (P <0.05). The nursing satisfaction rate in the experimental group was 95.74%, which was higher than 82.98% in the routine group, and the difference was statistically significant (P <0.05). Conclusion The implementation of refined nursing intervention in operating room for patients undergoing auricular reconstruction can not only reduce the occurrence of postoperative complications, but also help to improve the surgical efficiency and quality of surgery, and the patient satisfaction is high, which is worthy of clinical application.