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One of the damage control strategies used to avoid or treat abdominal compartment syndrome is "open abdomen (OA)," where the facial edges and the skin is left open, exposing the abdominal viscera. Although it reduces the mortality both in trauma and non-trauma abdominal complications, it does create a significant challenge in an intensive care setting, as it has physiological consequences that need early recognition and prompt treatment both in the intensive care unit and in the operating room. The article aims to review literature on "open abdomen," describe the challenges in such cases, and proposes a guideline for the intensivist in managing a patient with an OA. [ABSTRACT FROM AUTHOR]