Management of open abdomen remains challenging, often requiring specialized wound care to prevent infection, fluid loss, and delayed closure. This study evaluates the effectiveness of topical negative pressure therapy (TNPT) compared to conventional management. A retrospective analysis of 60 patients was conducted, divided into TNPT (n=30) and conventional groups (n=30). TNPT showed higher abdominal closure rates (76.7% vs. 50.0%), shorter time to definitive closure (13.4 vs. 18.9 days), and fewer surgical site infections (26.7% vs. 46.7%). Mortality rates were similar, while ICU stay was shorter in TNPT (11.2 vs. 15.6 days). TNPT may be an effective adjunct in open abdomen management.