〔Abstract〕 Objective To investigate the effects of Taohong Siwu Decoction on vascular crisis, survival rate of skin flap and total range of motion of fingers in patients with soft tissue defect of hand. Methods A total of 72 patients with hand soft tissue defect surgery admitted to Nanyang Hospital of Traditional Chinese Medicine from March 2020 to December 2022 were selected and divided into a control group and an observation group according to random number table method, with 36 cases in each group.The control group was treated with conventional western medicine, and the observation group was treated with Taohong Siwu Decoction. The coagulation indexes [activated partial thromboplastin time (APTT), prothrombin time (PT)], skin flap conditions [swelling degree, visual analogue scale (VAS), incidence of vascular crisis], skin flap survival rate and total finger motion were compared between the two groups. Results After treatment, the levels of APTT and PT in the observation group were higher than those in the control group, the differences were statistically significant (P < 0.05). The incidence of vascular crisis in the observation group was 11.11 %, lower than 33.33 % in the control group, the difference was statistically significant (P < 0.05). After treatment, the scores of swelling degree and VAS in the observation group were lower than those in the control group, the differences were statistically significant (P < 0.05). The skin flap survival rate and the excellent and good rate of total finger motion in the observation group were higher than those in the control group, and the differences were statistically significant (P < 0.05). Conclusion Taohong Siwu Decoction can effectively improve the coagulation function and skin flap condition, reduce the incidence of vascular crisis, increase the skin flap survival rate and the excellent and good rate of total finger motion in the treatment of patients with hand soft tissue defect.