Background:The aim ofthis study was to evaluate the feasibility ofthe seauential negatⅣe pressure wound theray(NPWT)and vascularized flap transplantation for diabetic patient with foot ulcer Methods:Twenty-eight diabetic patients with foot ulcers were treated by sequential therapy of NPWT and vascularized flap transplantation After debridement,all cases had one deep tissues exposed wound wlth different extent of wound 1nfection or poor wound vascularity A11 wounds received 1-3 sessions of NPWT to induce a well prepared wound bed At a later stage,22 patients received the ALT flaps transplantation to cover wounds on foot except the heel and the other 6 patients received medial plantar 1sland flap transplantation to cover wounds on the heel The flap survival and wound healing were followed up postoperatively Results: After NPWT-the wound 1nfection vv-as absent and the wound necrosis stabilized All patients who received vascularized flap transplantation at the second stage survived without intra-operative and post-operative complications During follow-up ranging from 16 to 58 months,the flaps and the affected foot were constantly integrity,with no secondary ulcer formation All the patients restored an almost normal gait and foot function after the surgery The donor site morbidity was minimal Conclusion:By a sequential therapy including NPWT for wound bed preparation and vascularized flap wound coverage,a stable,durable.and functional wound closure was achieved with reduced remedy period 1n treating diabetic patient wlth foot ulcer This sequential therapy can be used for diabetic foot ulcer management.