Objective To summarize nursing methods of vacuum sealing drainage (VSD)for plastic surgery patients with skin flap necrosis.Methods VSD was applied to 4 plastic surgery patients with skin flap necrosis in Middle Second Ward of Plastic Surgery Hospital,Chinese Academy of Medical Sciences.The effectiveness of VSD was retrospectively summarized and analyzed.Results Two patients with intercostalartery perforator flap had been treated with VSD for two cycles.There were massive fresh granulation tissue characterized with fine granules,abundant capillaries and no edema.The area of wound had decreased to 2 cm × 2 cm.Moreover,the wound recovered well after skin-graft repairing. One patient with ectatic sensate paraumbilical flap had been treated with VSD for one cycle.The area of wound had decreased to 1 cm ×1 cm and recovered after four times dressing change.The last case of patient with scapular flap had been treated with VSD for 3 cycles and the area wound had decreased to 2 cm ×3 cm.The wound recovered favorably after skin-graft repairing.There were no systemic or local toxicity,allergic reaction and complications in all four cases. Conclusions Application of VSD,which is worth of clinical expansion,is a simple-handling and effective treatment for plastic surgery patients with skin flap necrosis after debridement.