Objective To investigate the clinical efficacy of pedicled flap combined with vacuum sealing drainage in the repair of refractory wounds. Methods A total of 45 patients with refractory wounds admitted to our hospital from January 2020 to December 2022 were randomly divided into control group (22 patients) and experimental group (23 patients). The control group was repaired with pedicle flap, and the experimental group was repaired with pedicle flap combined with vacuum sealing drainage technique. The clinical related indexes and postoperative complications were compared between the two groups. Results The preoperative preparation time, dressing change times, wound healing time, antibiotic use time and total hospitalization cost of the experimental group were better than those of the control group (P<0.05). There was no significant difference in intraoperative blood loss between the two groups (P >0.05). The incidence of complications in the experimental group was 21.74%, which was lower than 31.82% in the control group, but the difference was not statistically significant (P>0.05). Conclusion Pedicle flap combined with postoperative vacuum sealing drainage is safe and effective in the treatment of refractory wounds, which can shorten the wound healing time, reduce the time of antibiotic use, improve wound infection without increasing the risk of complications. It is worthy of clinical application.