Objective To study the efficacy of ionic silver dressing combined with hydrogel in promoting refractory burn wound healing. Methods A total of 64 patients with refractory deep burn were recruited from the Department of Burn, Chengdu Hospital of Armed Police Forces, between April 2010 and April 2012. These patients were randomly divided into observation group (ionic silver dressing combined with hydrogel were used) and control group (wet povidone iodine at the concentration of 0.5 %, gauze, vaseline gauze, and the cotton pad layer were used). Secretions from the wound underwent bacterial culture at day 1, 5, 10, 15 and 25 after the excision of eschar or after debridement to record the healing condition and velocity while observing adverse reactions, wound painfulness, and granulation damage. Results The detection rate of wound bacteria in the observation group was significantly lower than that in the control group (P＜ 0.05). Fresh granulation growth time in the observation group was 7.0-8.0 days shorter than that in the control group. Fresh granulation grew significantly faster in the observation group than in the control group (P＜ 0.05). There were no adverse reactions in either group. Additionally, the observation group suffered no significant pain and no significant damage to granulation tissue during wound dressing. Conclusions The ionic silver dressing combined with hydrogel remarkably promotes regeneration of granulation tissue and epithelial cells while accelerating wound healing, without any adverse effect on the refractory burn wound healing.