Late salvage of a "free flap" phalloplasty: a case report.

Three weeks after radial forearm free flap phalloplasty, a 28-year-old female-to-male transsexual presented with ischaemia of the neophallus. A salvage procedure was started 7 hours after onset of ischemia. Thrombectomy of the arterial pedicle did not result in venous return of the arterial inflow. Perfusion of the flap with streptokinase restored venous return. Flap perfusion was confirmed by intraoperative direct angiography of the neophallus. Six months after this salvage procedure, the flap is doing well and tactile sensibility has occurred.