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In response, we designed an injectable, bio\u2010based hydrogel for ultrasound\u2010guided hemostasis. By chemically modifying natural polymers: hyaluronic acid, chitosan, and polylysine, and inducing a Schiff base reaction between aldehyde and amino groups at room temperature, the hydrogel forms instantly using a dual\u2010syringe system without requiring additional stimuli such as heat or light. After optimizing the formulation, the hydrogel (OPH) achieves a wet adhesion strength of approximately 45\u00a0kPa and can withstand a bursting pressure of 123\u00a0mmHg in intestinal wounds. The cationic components confer antibacterial activity against\n                    <jats:italic>Staphylococcus aureus<\/jats:italic>\n                    and\n                    <jats:italic>Escherichia coli<\/jats:italic>\n                    . In comparison with commercial hemostats (e.g., Surgicel, gelatin sponges), OPH matches coagulation performance while offering better suitability for deep wounds. In rabbit models of closed and lethal liver injuries, ultrasound\u2010guided in situ injection of OPH hydrogel effectively seals wounds and controls bleeding, reducing surgical pain and complications. The work introduces a high\u2010performance hemostatic platform enabled by a synergistic design: rapid covalent cross\u2010linking, intrinsic cationic activity, and ultrasound\u2010guided precise delivery. Together, these features provide a versatile reference for next\u2010generation trauma\u2010care materials.\n                  <\/jats:p>","DOI":"10.1002\/adhm.71187","type":"journal-article","created":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T08:55:37Z","timestamp":1776934537000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Ultrasound\u2010Guided Injectable Adhesive Hydrogel Enabling Targeted Hemostasis in Deep and Incompressible Wounds"],"prefix":"10.1002","volume":"15","author":[{"given":"Yadong","family":"Liu","sequence":"first","affiliation":[{"name":"School of Biomedical Engineering Shenzhen Campus of Sun Yat\u2010Sen University  Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han","family":"Yang","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering Shenzhen Campus of Sun Yat\u2010Sen University  Shenzhen China"},{"name":"Shenzhen 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