Abstract: Objective To study the clinical effect of vacuum sealing drainage (VSD) combined with split-thickness skin graft in the treatment of venous ulcer of lower extremity. Methods Total 40 cases of venous ulcer of lower extremity,included 14 cases of simple varicose vein combined with ulcer,12 cases of Cockett syndrome combined with ulcer,8 cases of Budd Chiari syndrome with ulcer,and 6 cases of lower extremity deep vein thrombosis associated with ulcer,were recruited in our hospital between January 2013 and April 2014.All patients were given conventional dressing and symptomatic treatment in order to achieve wound cleaner.The wound culture was performed and antibiotics were given on the basis of indications.Biopsy was performed for the larger ulcer wound to exclude the possibility of malignancy.For the patients with simple varicose vein combined with ulcer the split-thickness skin graft were performedsimultaneously;for the patients with Cockett syndrome,Budd Chiari syndrome or post thrombotic syndrome,the recanalization were performed and the split-thickness skin graft followed 3-7 days later.VSD was conducted for all patients. Results Forty patients were treat with VSD on average of 6 days.The skin grafts were all survived in 32 cases,survived 92% in 6 cases,and survived 60% in 2 cases,all wound were healed after dressing change.No case needs the second operation. Conclusion Effect of VSD combined with split thickness skin graft for venous ulcer were clear.VSD can reduce the tissue edema,improve local microcirculation,accelerate the fresh granulation tissue growth.At the same time,VSD with advantage of better wound drainage,control infection,promote wound attached,is conducive to the graft survival.