This study investigates the efficacy of the combination of extracellular matrix/stromal vascular fraction gel (ECM/SVF-gel) and vacuum sealing drainage (VSD) on chronic wounds. From February 2021 to February 2022, 20 patients with chronic wounds were recruited and were divided into experimental and control groups, with 10 patients in each group. Following debridement, we applied various treatments to all cases for 2 weeks. Subsequently, we observed the changes in the wound area and calculated the rate of wound healing. Simultaneously, the wound margin tissues were collected for histological analysis, and the inflammatory cell infiltration within the wound was assessed using HE staining. Masson staining was used to observe the collagen deposition on the wound surface, and CD31 immunohistochemistry was used to count the number of microvessels to evaluate the angiogenesis (Clinical trial registration number: ChiCTR-INR-17013540). The therapeutic outcomes for all cases included in this study were favorable after a 2-week treatment period, and the wound area was smaller than before. The experimental group exhibited a significantly higher rate of wound healing compared to the control group. In the experimental group as revealed by HE staining, there was a marked reduction in the infiltration of inflammatory cells in the dermis. Masson staining demonstrated that the deposition of collagen fibers in the experimental group was more than the control group. CD31 immunohistochemistry showed an increased number of new blood vessels in the experimental group compared to the control group. Additionally, ECM/SVF-gel extract significantly enhanced the fibroblast proliferation and migration in vitro. The application of ECM/SVF gel combined with VSD in chronic wounds can accelerate wound healing by reducing inflammatory reaction, increasing collagen fiber deposition, and promoting angiogenesis. Therefore, the combination of ECM/SVF gel and VSD can be used as a simple, safe, and effective therapeutic method for chronic wounds.