Objective To observe the application effects of operating room skin management on postoperative pressure sores prevention in orthopedic patients. Methods A total of 138 patients who underwent orthopedic surgery in our hospital were randomly divided into control group and observation group, with 69 cases in each group. Control group was treated with routine operating room nursing, and observation group was treated with operating room skin management nursing on the basis of control group. Nursing quality, postoperative skin conditions, incidence rate of pressure sores and nursing satisfaction were observed in the two groups. Results The scores of nursing quality (health education, position guidance, adjustment of compression site, damp-proof treatment, intraoperative warming, promotion of blood circulation) in observation group were significantly higher than those in control group (P<0.05). The skin redness rate in observation group after operation was significantly higher than that in control group (P<0.05). The incidence rate of pressure sores in observation group within 7d after operation was significantly lower than that in control group (P<0.05), and the patients’ satisfaction was significantly higher than that in control group (P<0.05). Conclusions Operating room skin management can improve the nursing quality and nursing satisfaction of patients, and effectively prevent postoperative pressure sores in patients with orthopedic surgery.