Topic: The use of living bi-layered skin substitute as a part of a wound healing management strategy has shown positive outcomes for patients with leg ulcer disease. Critical to the successful outcomes for these products is assuring an atmosphere for these substitutes to proliferate and adhere to the wound. Providing an environment with optimal levels of moisture and stability is critical for adherence and successful "takes." The Wound Healing Institute(WHI) of Self Regional Healthcare identified and trailed a soft silicone transfer dressing that has proven to be reliable in providing success with these applications. Objective: This poster will provide the reader with a history of management strategies, and detailed information and images regarding the application utilizing a soft silicone transfer dressing. From this poster, the reader will be able to observe the process of application and ease of use to promote adherence as well as stabilization of the tissue substitute. This poster will review three cases where the application of bi-layered skin substitute was secured with a soft silicone transfer dressing and an absorbent outer layer. Outcomes: (1)The use of soft silicone transfer dressing allows the bi-layered skin substitute to adhere and incorporate into the wound without floating or moving through exudate management and stabilization. (2) Cost savings due to decreased re-application of substitute, nursing and physician time are recognized. (3) Average healing time has decreased in the cases presented contrasted with cases using other dressing methods. (4) Pain level for patients has decreasd with the healing of these leg ulcers. Conclusion: The WHI of Self Regional Healthcare, a comprehensive wound center, identified a unique application strategy using s soft silicone transfer dressing to promote successful outcomes for bi-layered tissue applications. Challenges to successful application of skin substitutes are establishing exudate management and an environment of security.