The Open abdomen (OA) is a temporary therapeutic measure employed in circumstances where the abdomen either cannot be closed or should not be closed. Clinically, it is used in such settings as abdominal catastrophe, acute fascial dehiscence, or emergent abdominal surgery in the setting of a pre-existing large ventral hernia. It is utilised after damage control surgery to mitigate against the development of abdominal hypertension and abdominal compartment syndrome. Historically, the viscera were managed with some form of temporary abdominal containment (TAC) until skin grafting and eventual repair of a planned ventral hernia. Static TAC methods resulted in low fascial closure rates, more complications, a high rate of enteroatmospheric fistula (EAF), higher mortality and more difficult hernias to repair with a high recurrence rate. These were found to be less effective than those techniques achieving early primary fascial closure. Dynamic closure methods combined with negative pressure wound therapy give the best results. The talk will present the current preferred techniques, including the role of Botulinum toxin and the use of intraoperative fascial traction (FasciotensTM).