Objective To observe the clinical effects of tangential excision and skin grafting combined with vacuum sealing drainage （VSD） and nano silver medical antibacterial dressing in treating deep burn patients. Methods From October 2021 to October 2023，106 deep burn patients were randomly divided into two groups using a random number table method. The control group consisted of 53 patients who underwent tangential excision and skin grafting combined with VSD， while the research group consisted of 53 patients who underwent tangential excision and skin grafting combined with VSD and nano silver medical antibacterial dressings. The two groups were compared in terms of condition of healing， recovery indicators， pain inducing factors， inflammatory indicators， vascular endothelial growth factor （VEGF） ， matrix metalloproteinase-9（MMP-9）， infection indicators， complications， and antibiotic usage. Results The healing of the research group was superior to that of the control group （P<0.05）. The wound healing time and hospital stay of the research group were shorter than those of the control group （P<0.05）. After treatment， the levels of 5-hydroxytryptamine， prostaglandin E2， C-reactive protein （CRP）， tumor necrosis factor- α（TNF- α）， MMP-9， white blood cell count， neutrophil ratio， procalcitonin， and heparin-binding protein in the research group were lower than those in the control group （P<0.05）， and all were lower than those before treatment （P<0.05）. After treatment， the VEGF， platelet count， and blood calcium in the research group were higher than those in the control group （P<0.05）， and all were higher than those before  treatment （P<0.05）. The infection rate of the research group was lower than that of the control group （P<0.05）， while the scar hyperplasia rate， the skin graft displacement rate， and the incidence of blood accumulation and fluid in the wound area were not statistically different from those of the control group （P<0.05）. The antibiotic usage rate of the research group was lower than that of the control group （P<0.05）； the antibiotic usage time of the research group was shorter than that of the control group （P<0.05）. Conclusion The combination of tangential excision and skin grafting with VSD and nano silver medical antibacterial dressings