Abstract：Objective：To observe the effect of the therapy of Taohong Siwu Decoction combined with fascial flap repair of dorsal thumb on flap survival rate of patients with fingertip soft tissue defect. Methods ： A total of 80 patients with fingertip soft tissue defects treated at the Second People's Hospital of Haining from December 2022 to April 2023 were selected as the study subjects and randomly divided into the control group and the treatment group， with 40 patients in each group.The control group was given conventional treatment after surgery，and the treatment group was additionally treated with Taohong Siwu Decoction on the basis of the treatment of the control group. Both groups were treated for seven days. The clinical effects，flap survival rates and coagulation function were compared between the two groups. Results：The total effective rate was 95.00% （38/40） in the treatment group，higher than that of 77.50% （31/ 40） in the control group（ P＜0.05）. The flap survival rate was 95.00%（ 38/40） in the treatment group，higher than that of 77.50%（31/40） in the control group （P＜0.05）. On the seventh day after surgery， the activated partial thromboplastin time （APTT） and prothrombin time （PT） in the two groups were longer than those before surgery，and the fibrinogen （Fib） levels were lower than those before surgery （P＜0.05）；the PT and APTT in the treatment group were longer than those in the control group， and the Fib level was lower than that in the control group （P＜0.05）. Conclusion： The therapy of Taohong Siwu Decoction combined with fascial flap repair of dorsal thumb has a great curative effect on patients with fingertip soft tissue defect， which can increase the flap survival rate and improve the coagulation function.