Management of the open abdomen was first documented by Ogilvie in 1940 for use in combat patients [1]. Temporary clo­sure was performed with light canvas or strut cotton sutured to the fascia with catgut, with vaseline gauze swabs tucked under the fascia, and the abdomen was closed with sutures or strips of Elastoplast [1, 2]. He recognized that the septic abdomen should be treated like other septic wounds, with incision and drainage [2]. Studies of the open abdomen began to appear in the literature 40 years later, with high reported rates of mor­bidity and mortality [2]. Before 1980, patients with severe intra-abdominal trauma or sepsis were generally treated with one definitive operation, and patients died from the complica­tions of acidosis, hypothermia, coagulopathy, and “failure to resuscitate.” Patients who required re-exploration had their fascia closed and reopened at the next operation. Through the 1980s, trauma surgeons began to recognize the benefit of a staged approach, and in 1993 Rotondo coined the term “dam­age control laparotomy,” leaving the abdomen open between explorations. The traditional approach was to manage the open abdomen as a planned ventral hernia, where a split­thickness skin graft was placed over a granulated tissue bed on the intestines, and the patient underwent definitive abdominal wall reconstruction 6–12 months after discharge. This approach was followed through the 1990s–2000s. Today, it is acceptable, and even preferred, to attempt definitive closure during the initial hospitalization [2, 3].