To compare real-world outcomes of di erent wound care strategies following surgical debridement in scrotal-con ned Fournier Gangrene (FG), without inferring causality. Study Design: Observational study. Place and Duration of the Study: Department of Urology, Aydin Adnan Menderes University, and Ege University, Izmir, Turkiye, from August 2013 to October 2023. Methodology: Eighty-six patients with scrotal-con ned FG were included. They were divided into three postoperative wound care groups: Group 1 used gauze impregnated with rifampicin and nitrofurantoin, Group 2 used rivanol-impregnated gauze, and Group 3 used vacuum-assisted closure (VAC). Data on demographics, microbial pro les, antibiotic use, and clinical outcomes (including hospital stay) were recorded. Group comparisons were performed using one-way ANOVA, Kruskal Wallis, or Chi-square tests as appropriate. Results: The patients age ranged from 26 to 96 years (mean 63.9 years). The most common single morbidity was diabetes (29.1%). Predominant pathogens were polymicrobial (24.4%) and E. coli (23.3%) in isolation. Overall mortality was 5.8%. Median hospital stays were 9 days (range: 5 28) in Group 1, compared to 14 days (6-40) and 15 days (6-31) in Groups 2 and 3, respectively (p <0.001), with Group 1 being signi cantly shorter. Secondary debridement rates were similar across groups: 12.5% in Group 1, 37.5% in Group 2, 50% in Group 3 (p = 0.32). Antibiotic choices di ered signi cantly among the groups (p <0.001). Notably, the triple combination regimen of daptomycin, tigecycline, and meropenem was not used in Group 1. Conclusion: Topical antibiotic dressing using mesh dressings impregnated with rifampicin and nitrofurantoin was associated with a shorter hospitalisation compared to rivanol and VAC therapy in scrotal-con ned FG. These ndings suggest that rifampicin and nitrofurantoin-based topical therapy may be viable alternatives in resource-limited settings, or where VAC is unavailable.