Introduction: The aim of the study was to examine the relationship between skin reconstruction and systemic inflammatory index (SII), procalcitonin in Fournier’s gangrene. Methods: Forty-seven male patients who underwent debridement and were diagnosed with Fournier’s gangrene were included in this retrospective study. The patient groups were divided into two groups. Group 1 included 26 patients who required primary skin closure, and Group 2 included 21 patients who required skin grafts and flaps. Data regarding initial symptoms, physical examination findings, vital signs, and laboratory tests were collected through archive scanning. Patients with available data for the Fournier’s gangrene severity index (FGSI), Uludağ’s Fournier’s gangrene severity index (UFGSI), procalcitonin, C-reactive protein (CRP), and SII calculations were included in the study. Results: A significant difference in vital signs was found between the groups. Fever, pulse and respiratory rate were significantly greater in Group 2 than in Group 1 (p = 0.747). There was no significant difference in body mass index (BMI) or duration of hospitalization (p = 0.983). The average procalcitonin level of the patients measured preoperatively was 1.01 in Group 1 and 2.30 in Group 2. In Group 1, the average CRP level was 111.90, the SII was 3,460.00; in Group 2, the CRP level was 165.00, the SII was 6,544.00, and this difference between the two groups was significant (p = 0.011–0.018). Conclusion: CRP, procalcitonin, and SII rates can be measured simply, easily applied, and can provide insight into predicting skin reconstruction.

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