Objective To explore the effect of silicone adhesive foam dressing combined with calcium alginate dressing in skin graft donor sites. Methods A total of 60 patients admitted to the Department of Plastic and Burn Surgery, Guizhou Provincial People's Hospital from January 2023 to December 2024 were selected, and they were divided into the control group and the observation group by the random number table method, with 30 patients in each group. The control group was treated with petrolatum gauze coverage+semi-exposed therapy, and the observation group was treated with silicone adhesive foam dressing combined with calcium alginate dressing to cover the wound. The wound healing, pain degree, wound bacterial content and scar hyperplasia were compared between the two groups. Results The wound healing rates of the observation group at 7, 10 and 13 days after operation were higher than those of the control group (P <0.05). The VAS scores of the observation group at 7, 10 and 13 days after operation were lower than those of the control group (P <0.05). The wound bacterial content of the observation group at 7, 10 and 13 days after operation was lower than that of the control group (P <0.05). The VSS scores of the observation group at 3 and 6 months after operation were lower than those of the control group (P <0.05). Conclusion The application of silicone adhesive foam dressing combined with calcium alginate dressing to cover wounds in skin graft donor sites has a good effect. It can promote wound healing, alleviate pain, help to reduce wound bacterial content and prevent scar hyperplasia, which is worthy of clinical application.