Objective To investigate the effectiveness and practicality of the sequential therapy of refractory wounds with vacuum sealing drainage technique and skin flap transplantation.Methods Since October 2009,the combination of VSD and Skin flap transplantation has been applied in the sequential therapy of 30 patients with refractory wounds caused by various reasons.First,the VSD is applied to make preparations for wound repair and then skin flaps are used to repair the various wounds.At the same time or later,VSD is used to improve the survival ratio of flaps transplantation or to treat complications of skin flap transplantation.Results The wounds recovered satisfactorily after sequential therapy with vacuum sealing drainage technique and skin flap transplantation.When the VSD is removed or renewed,the surface of wound is narrowed,infection controlled.and granulation refreshed,the good results are also acquired when the VSD is used to improve the survival ratio of flap transplantation or to treat complications of skin flap transplantation.Conclusions The sequential application of Vacuum Sealing Drainage(VSD) combined with skin flap transplantation to repair refractory wounds will come to a better result.