Abstract: Objective To investigate the characteristics and cautions of conventional vacuum sealing drainage(VSD) and improved VSD for full-thickness wounds and refractory wounds.Methods Eight cases of postoperative unhealed limb wounds with bone and plate exposure and recurrent infections received conventional VSD and 3 of them were further treated with improved VSD.Granulation tissue formation,bacterial infection and wound healing were observed.Results The dressing was removed on day 14-21 in all patients.In 5 of the 8 patients,granulation tissue grew at a fast rate which was suitable for skin or flap transplantation and wound healing.Improved VSD was further performed in other 3 patients who had wound infection after debridement,suturing and skin flap transplantation.After improved VSD treatment for 14 days,the debridement,suturing,and skin or flap transplantation were performed again,and then the wounds healed.Conclusion The VSD can promote granulation tissue formation and wound healing.The improved VSD can further reduce wound infection and accelerate wound healing for full-thickness wounds and refractory wounds with recurrent infection and recurrent sinuses.