Objective To explore the application effect of vacuum sealing drainage combined with silver ion dressing in the treatment of refractory burn wounds. Methods A total of 80 patients with refractory burns admitted to Jingshan People's Hospital from August 2021 to February 2023 were selected as the research objects. They were divided into control group and experimental group by random number table method, with 40 patients in each group. The control group was treated with vacuum sealing drainage (VSD), and the experimental group was treated with vacuum sealing drainage combined with silver ion dressing. The wound recovery, clinical indicators, pain degree, bacterial detection rate of wound secretion and incidence of complications were compared between the two groups. Results The wound red period time, wound healing time and dressing maintenance time in the experimental group were better than those in the control group (P<0.05). The frequency of dressing change, hospitalization time and total cost of treatment in the experimental group were better than those in the control group (P<0.05). After treatment, the VAS score of the experimental group was lower than that of the control group (P<0.05). The bacterial detection rate of wound secretion in the two groups after treatment was lower than that before treatment, and that in the experimental group was lower than that in the control group (P<0.05). The incidence of complications in the experimental group was 2.50%, which was lower than 15.00% in the control group (P<0.05). Conclusion Vacuum sealing drainage combined with silver ion dressing is effective in the treatment of refractory burn wounds, which can effectively promote wound healing, improve the utilization rate of dressings, reduce pain, and reduce the detection rate of bacteria in wound secretions and the incidence of complications. Meanwhile, it is beneficial to promote the rapid recovery and discharge of patients, reduce the cost of treatment, and reduce the economic burden of patients.