Objective To analyze the effect of pain management combined with solution-focused brief psychological intervention on pain intensity and appearance satisfaction in patients undergoing skin grafting for burn reconstruction. Methods A total of 100 patients who underwent skin grafting for burn reconstruction in our hospital from January 2022 to December 2024 were selected, and they were divided into the control group and the observation group by the random number table method, with 50 patients in each group. The control group received conventional nursing, and the observation group received pain management combined with solution-focused brief psychological intervention on the basis of the control group. The pain intensity, appearance satisfaction, wound healing time, coverage rate of surviving skin graft wounds and complication rate were compared between the two groups. Results There was no statistically significant difference in VAS score between the two groups at 6 hours after surgery (P>0.05). The scores of VAS in the observation group at 24 hours and 3 days after operation were lower than those in the control group (P<0.05). The appearance satisfaction rate of the observation group (94.00%) was higher than that of the control group (80.00%) (P<0.05). The wound healing time of the observation group was shorter than that of the control group, and the coverage rate of surviving skin graft wounds was higher than that of the control group (P<0.05). The incidence of complications in the observation group (6.00%) was lower than that in the control group (18.00%) (P<0.05). Conclusion Pain management combined with solution-focused briefpsychological intervention can not only reduce the pain intensity of patients undergoing skin grafting for burn reconstruction and improve their appearance satisfaction, but also promote wound healing, increase the coverage rate of surviving skin graft wounds, and help to reduce the incidence of complications, achieving an ideal nursing effect.