Abstract: To enhance the medical performance of gauze, by grafting itaconic acid onto the surface of cotton gauze material fibers, complexing zinc ions with the carboxyl group of itaconic acid, and generating ZnO nanoparticles by boiling in high-temperature water with sodium hydroxide. This simple and efficient synthesis method retains the hygroscopicity of the gauze dressing while endowing the gauze with excellent antibacterial properties. The cotton gauze samples before and after treatment were characterized by XRD, SEM and EDS. The cotton gauze coated with zinc oxide could achieve an antibacterial effect of up to 99% against Gram-negative bacteria Escherichia coli (E. coli) and Gram-positive bacteria Staphylococcus aureus (S. aureus). More importantly, in vitro cytotoxicity tests revealed that the gauze had relatively low toxicity. When zinc oxide gauze was applied to skin defect wounds, the appropriate release of zinc ions could reduce the inflammatory response at the wound site, promote vascular proliferation at the wound site, and thereby accelerate wound healing. In addition, the physical and mechanical property tests of this antibacterial zinc oxide composite gauze found that the breaking strength of the antibacterial gauze increased to 80 N, and the capillary effect also reached 10.75 cm/30 min. Based on this, this antibacterial gauze has shown great application value in the field of medical dressings.