Objective To explore the effect of vacuum sealing drainage combined with adjacent ffap transposition in patients with pressure injury. Methods A total of 60 patients with pressure injury admitted to our hospital from January 2023 to July 2025 were selected, and they were divided into the control group and the observation group by the random number table method, with 30 patients in each group. The control group was treated with vacuum sealing drainage, and the observation group was treated with vacuum sealing drainage combined with adjacent flap transposition. The treatment success rate, wound area and depth, wound healing status, pain intensity and sleep quality were compared between the two groups. Results The treatment success rate of the observation group (96.67%) was higher than that of the control group (80.00%) (P<0.05). The wound area and depth in the two groups after treatment were better than those before treatment, and those in the observation group were better than those in the control group (P<0.05). The wound healing time, wound skin color recovery time and wound secretion disappearance time in the observation group were shorter than those in the control group (P<0.05). The scores of NRS and PSQI in the two groups after treatment were lower than those before treatment, and those in the observation group were lower than those in the control group (P<0.05). Conclusion The application of vacuum sealing drainage combined with adjacent flap transposition in patients with pressure injury has an ideal effect, which can greatly promote wound healing, shorten wound healing time, help to relieve wound pain and improve sleep quality of patients.