Abstract: OBJECTIVE To observe the difference in the incidence of postoperative surgical site infections (SSIs) between the patients undergoing hand pedicle flap transplantation and the patients undergoing free skin flap transplantation and analyze the influencing factors so as to provide guidance for prevention of infections and enhancement of safety management of the patients. METHODS A total of 92 patients who were hospitalized in hand surgery department of Henan People's Hospital and underwent hand skin flap transplantation were recruited as the research subjects and were divided into the favorable incision healing group with 80 cases and the SSI group with 12 cases according to the status of postoperative incision healing; the enrolled patients were divided into the pedicle flap group with 73 cases and the free flap group with 19 cases according to the type of skin flap used during the surgery. The clinical characteristics were observed and compared between the two groups of patients by means of SPSS 25.0 software. RESULTS The proportions of patients who had crush injuries of blunt instruments/heavy objects, underwent free skin flap transplantation and had skin flap-associated adverse events were higher in the SSI group than in the favorable incision healing group(P＜0.05); the length of hospital stay was the risk factor for SSI in the patients undergoing skin flap transplantation (OR=1.080,95%CI:1.015 to 1.148). The proportions of patients who had SSI and skin flap-associated adverse events were higher in the free skin flap group than in the pedicle flap group (31.58% vs. 8.22%,P=0.015;21.05% vs. 4.11%,P=0.031). The length of hospital stay, time of use of antibiotics and operation duration of the free skin flap group were longer than those of the pedicle flap group, and the hospitalization cost of the free skin flap group was more than that of the pedicle flap group (all P＜0.05). CONCLUSIONS The SSI may lengthen the hospital stay and increase the economic burden. The patients with free skin flap and crush injuries of blunt instruments/heavy objects are more likely to have SSI. It is necessary to attach more attention to the cleaning and disinfection management of surgical incisions for such group of patients and reasonably use antibiotics so as to prevent the incision infections.