<p>Rapid wound closure is crucial to prevent microbial invasion during skin trauma. Delayed diagnosis and treatment of wound infection may lead to complications such as impaired healing and sepsis. Conventional clinical dressings (e.g., cotton and gauze) mainly provide physical isolation but fail to establish an antibacterial microenvironment. These dressings often adhere to wound tissues, resulting in secondary injury during removal, and lack the capability for real-time monitoring of wound conditions. This study innovatively integrates multimodal pressure sensing with wound repair functions, enabling the synergistic development of smart sensing wound dressings (SSWD) that offer real-time visual monitoring. The dressing employs gradient cross-linking to fabricate a dynamic self-adaptive Janus-structured organic hydrogel. The upper non-adhesive ion-sensing layer incorporates micro-nano surface structures, enabling high-resolution real-time responses to mechanical signals from wound swelling and tissue regeneration. This capability, when coupled with an image acquisition system, enables visual monitoring of the healing process. The lower adhesive layer ensures robust interfacial integration with the wounds’ bed via hydrogen bonding while allowing controlled sustained release of drugs that promote healing. This system propels the development of intelligent dressings towards diagnosis-treatment integration and offers an innovative solution for precision wound management.</p>