Objective To analyze the application value of autologous fat transplantation (AFT) combined with vacuum sealing drainagein (VSD) the treatment of chronic wounds. Methods Sixty patients with chronic wounds received in our hospital from April 2021 to April 2023 were randomly divided into control group and observation group, with 30 patients in each group. The control group was treated with conventional debridement and dressing change, and the observation group was treated with AFT combined with VSD. The wound healing rate, complication rate, positive rate of bacterial culture, wound granulation growth score, average wound healing time, hospitalization time, inflammatory factors, pain-causing factors and pain scores, ulcer-related indicators were compared between the two groups. Results The wound healing rate and wound granulation growth score of the observation group were higher than those of the control group, the incidence of complications and the positive rate of bacterial culture were lower than those of the control group, and the average wound healing time and hospitalization time were shorter than those of the control group (P <0.05). After treatment, the improvement of inflammatory factors, pain-causing factors and pain scores, ulcer-related indicators in the observation group were better than those in the control group (P <0.05). Conclusion VSD combined with AFT is effective in the treatment of chronic wounds, and it is not easy to cause local and systemic adverse reactions, which is a stable, ef fective and safe treatment method.