Objective To investigate the effect of vacuum sealing drainage combined with skin graft repair in patients with chronic wounds. Methods A total of 78 patients with chronic wounds admitted to Huiji Hospital affiliated of Hubei Polytechnic Institute from May 2023 to May 2024 were selected as the research objects. They were divided into control group (n =39) and experimental group (n =39) by random number table method. The control group was treated with routine wound dressing change combined with skin graft repair, and the experimental group was treated with vacuum sealing drainage combined with skin graft repair. The clinical efficacy, clinical related indicators and complications of the two groups were compared. Results The total effective rate of treatment in the experimental group was 97.74%, which was higher than 79.49% in the control group, and the difference was statistically significant (P <0.05). The VAS score of the experimental group was lower than that of the control group, the number of dressing changes was less than that of the control group, and the wound healing time was shorter than that of the control group, the differences were statistically significant (P <0.05). The incidence of complications in the experimental group was 7.69%, which was lower than 25.64% in the control group, and the difference was statistically significant (P <0.05). Conclusion The application of vacuum sealing drainage combined with skin grafting in the treatment of patients with chronic wounds is effective. It can not only improve the total effective rate of treatment, but also reduce the degree of pain, reduce the number of dressing changes, and shorten the wound healing time. Manwhile, the incidence of postoperative complications is low, and the application safety is high.