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Herein, we report an injectable hydrogel (denoted as PACmC) with rapid coagulation, ultrahigh burst pressure tolerance, and low swelling properties for emergency hemostasis and long\u2010term wound management. PACmC hydrogel is formed by electrostatic self\u2010assembly of aminated carboxymethyl chitosan (ACmCS) into nanoparticles, which are then crosslinked with NHS\u2010activated tetra\u2010arm polyethylene glycol (Tetra\u2010PEG\u2010SS) via rapid NHS\u2010amine coupling, yielding gelation within 22.3 s. The positively charged ACmCS nanoparticles actively aggregate blood components to accelerate hemostasis, while their densely packed network physically restricts water infiltration, resulting in low swelling ratio of only 49.2% within 7 d. For tissue adhesion, the NHS\u2010ester groups on Tetra\u2010PEG\u2010SS covalently bond with amino groups on the wound surface, and ACmCS nanoparticles serve as multivalent crosslinking centers that enhance cohesive strength, together enabling robust wet\u2010tissue adhesion (46.5\u00a0kPa) and an ultrahigh burst pressure tolerance of 701\u00a0mm Hg. In rabbit and porcine models of hepatic and splenic hemorrhage, PACmC hydrogel achieves rapid hemostasis and maintains long\u2010term sealing compared to clinical hemostats (thrombin powder and gauze), providing a new direction in developing novel hemostatic materials.<\/jats:p>","DOI":"10.1002\/advs.75329","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T08:59:48Z","timestamp":1777021188000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Injectable Hydrogel with Rapid Coagulation, Low Swelling, and High Burst Pressure Tolerance Properties for Long\u2010Term Management of Bleeding Wound"],"prefix":"10.1002","volume":"13","author":[{"given":"Yang","family":"Ouyang","sequence":"first","affiliation":[{"name":"Colorectal Surgery Unit III Guangdong Institute of Gastroenterology Biomedical Innovation Center Key Laboratory of Human Microbiome and Chronic Diseases Sun Yat\u2010sen University Ministry of Education Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases The Sixth Affiliated Hospital Sun Yat\u2010sen University  Guangzhou P. 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China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2617-5245","authenticated-orcid":false,"given":"Zixin","family":"Chen","sequence":"additional","affiliation":[{"name":"Colorectal Surgery Unit III Guangdong Institute of Gastroenterology Biomedical Innovation Center Key Laboratory of Human Microbiome and Chronic Diseases Sun Yat\u2010sen University Ministry of Education Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases The Sixth Affiliated Hospital Sun Yat\u2010sen University  Guangzhou P. R. 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