This article describes the aetiology of medical device-related pressure ulcers (MDRPU) and the vicious cycle that leads to these (typically, hospital-acquired) injuries. In this cycle, the primary, deformation-inflicted cell damage leads to a secondary inflammatory oedema-related damage and then to tertiary ischaemic cell and tissue damage. These three damage factors act cumulatively, and, once the first deformation-inflicted massive cell death initiates in the distorted tissues, each of these factors escalates the cell death and tissue damage further, under and near the applied medical device. The primary pathophysiological factors of the COVID-19 pandemic — including the cytokine storm, hypoxia and hyper-coagulation, which are typical to seriously ill patients who require life-support (skin-contacting) medical devices — can fuel the damage spiral of pressure injury. A continuous positive airway pressure (CPAP) mask is a classic example of a commonly used medical device … read more