Objective To explore the effect of integrated medical and nursing care on wound repair and negative emotions in patients with open tibial fracture complicated with skin and soft tissue defect. Methods A total of 92 patients with open tibial fracture complicated with skin and soft tissue defect admitted to the Department of Traumatic Orthopedics, Guigang City People's Hospital from January 2022 to July 2025 were selected. According to the random number table method, they were divided into the control group and the observation group, with 46 patients in each group. The control group received conventional nursing, and the observation group received integrated medical and nursing care. The wound repair, skin aesthetics, negative emotions and nursing satisfaction were compared between the two groups. Results The excellent and good rate of wound healing in the observation group was higher than that in the control group (P<0.05). At 3 months after surgery, the score of skin aesthetics in the observation group was lower than that in the control group (P<0.05). The scores of SAS and SDS in the observation group after nursing were lower than those in the control group (P<0.05). The nursing satisfaction of the observation group was higher than that of the control group (P<0.05). Conclusion The application of integrated medical and nursing care in patients with open tibial fracture complicated with skin and soft tissue defect can promote wound repair, improve skin aesthetics, alleviate negative emotions and enhance nursing satisfaction.