Figure 3.

Correct method for application of CETE device.¹⁰ One controller and six skin anchors should be used per 10 cm wound length. Additional anchors and controllers may be used for larger wounds. (A) Before applying the device, undermine or elevate the skin wound margins and close as much of the wound as possible. (B) Place skin anchors 0.5–1 cm from the wound edge, and ∼2–3 cm apart. (C) Secure the skin anchors with two standard wide skin staples (6–7 mm). (D) Place a barrier dressing on the wound bed and under the wound margins. Xeroform^® (petrolatum impregnated gauze), DuoDERM, or other barrier dressings may be placed on the wound bed and under the wound margins before attaching the tension controller line to the skin anchors. Place the tension controller at the widest part of the wound and thread the tension line through the skin anchors in a shoelace pattern. The tension controller can be loosely secured to the skin with either sutures or tape. Placing a protective barrier (e.g., DuoDERM) under the controller is recommended to minimize chances of skin blistering, compression, and ulceration. Gauze should not be placed under the tension controller as this can cause blistering. The wound may be dressed as required. (E) Turn the blue dial on the controller clockwise until a click is heard, then lock the controller by pressing the button. When the tension is set and the controller locked, no additional tightening is required.