Objective To compare the effects of high negative pressure drainage and conventional drainage on postoperative blood loss and wound healing in patients with calcaneal fracture. Methods A prospective randomized controlled single-blinded trial was conducted on the 66 patients with closed calcaneal facture who had been treated from June 2012 to March 2016 in our hospital. They were randomized by coin into 2 groups: 36 patients (aged from 21 to 65 years with a mean age of 38.1 years) were treated with a high vacuum drainage system while the other 30 (aged from 19 to 66 years with a mean age of 37.5 years) with a conventional silicone tube and a drainage vessel. The 2 groups were treated by the same team of surgeons and the same surgical procedures. The 2 groups were compared in terms of postoperative drainage volume, hemoglobin (HGB), bleeding volume, wound healing time, incision complications and wound infection. Results The high negative pressure group incurred significantly greater drainage volume (516.7 ± 138.8 mL) and bleeding volume (612.9 ± 179.5 mL) than the conventional drainage group (305.8 ± 95.4 mL and 437.8 ± 102.0 mL) (P <0.05). The former incurred significantly less HGB (116.8 ± 6.9 g/L) and wound healing time (15.2 ± 3.1 d) than the latter (124.1 ± 7.8 g/L and 18.5 ± 4.2 d) (P <0.05). The rate of incision complications for the high negative pressure group (5.6%, 2/36) was significantly lower than that for the conventional drainage group (26.7%, 8/30) (χ2=4.150, P=0.042). There was no significant difference between the 2 groups in the rate of wound infection (0 versus 3.3%) (P=0.927). Conclusion After surgery for calcaneal fractures, high negative pressure drainage may lead to faster wound healing and fewer postoperative wound complications but greater blood loss and lower HGB than conventional drainage.