Open abdomen treatment (OAT) is increasingly used, most often to prevent intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) after emergency abdominal surgery. The goal of temporary abdominal closure (TAC) techniques no longer is abdominal coverage alone, but fluid control and facilitation of early fascial closure are now important aspects. Various methods are available, but negative pressure therapy seems to be best suited to achieve these goals. Fascial approximation techniques prevent lateral retraction of the abdominal muscles and can be combined with TAC techniques. Mesh-mediated vacuum-assisted wound closure is emerging as one of the most promising approaches for OAT. In the intensive care unit, continued attention to IAH/ACS and measures to prevent or treat these conditions is imperative.