Objective To explore the effect of trauma graded nursing management on pain intensity and nursing satisfaction in patients after skin laser surgery. Methods A total of 80 patients who underwent skin laser surgery in Tongji Hospital, Tongji Medical College of HUST from August 2024 to July 2025 were selected as the research subjects, and they were divided into the control group and the observation group by the random number table method, with 40 patients in each group. The control group received conventional postoperative nursing, and the observation group received trauma graded nursing management. The psychological status, pain intensity, wound recovery time and nursing satisfaction were compared between the two groups. Results The scores of SDS and SAS in the observation group after nursing were lower than those in the control group (P<0.05). The VAS scores at 24 h, 72 h and 7 d after operation in the observation group were lower than those in the control group (P<0.05). The incrustation time, wound recovery time and decrustation time in the observation group were shorter than those in the control group (P<0.05). The scores of all nursing satisfaction indicators and total score on the 14th day after operation in the observation group were higher than those in the control group (P<0.05). Conclusion The application of trauma graded nursing management after skin laser surgery can effectively improve the psychological status of patients, relieve pain intensity, promote wound healing and improve nursing satisfaction.