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Cerebrospinal fluid (CSF) leak and pseudomeningocele are common complications after surgery for spinal dysraphism.We report a 6-month-old girl with a lumbosacral lipomyelomeningocele and accessory lower limb who developed a refractory cerebrospinal fluid leak and pseudomeningocele after lipomyelomeningocele repair and removal of the accessory limb. The pseudomeningocele was successfully repaired using a reversed dermis flap made from excess skin that covered the meningocele.This technique can be performed without using synthetic material or an additional surgical incision.

Objective: We present a case of exposure of a microvascular anastomotic coupler. Methods: We performed venous anastomoses using microvascular anastomotic couplers in head and neck reconstruction. Results: A microvascular anastomotic coupler was exposed in the seventh month postoperation, and an anastomosed vein was disrupted. Conclusions: Although the usefulness of the microvascular anastomotic coupler in microsurgical flap reconstruction is not in doubt, as described previously, we believe that it is necessary to remember that use of a microvascular anastomotic coupler involves potential risks of exposure and anastomosed vessel disruption.