Medical textiles have played an increasingly important protection role in the healthcare industry. This study was aimed at improving the conventional cotton gauze for achieving advanced biomedical specifications (coloration, UV-protection, anti-inflammation, and antimicrobial activities). These features were obtained by modifying the cotton gauze fabrics via in-situ precipitation of hydroxyapatite nanoparticles (HAp NP), followed by in-situ photosynthesis of silver (Ag) NPs with ginger oil as a green reductant with anti-inflammation properties. The HAp-Ag NPs coating provides good UV-protection properties. To further improve the HAp and Ag NPs dispersion and adhesion on the surface, the cotton gauze fabrics were modified by cationization with chitosan, or by partial carboxymethylation (anionic modification). The influence of the cationic and anionic modifications and HAp and Ag NPs deposition on the cotton gauze properties (coloration, UV-protection, antimicrobial activities, and water absorption) was thoroughly assessed. Overall, the results indicate that chemical (anionic and cationic) modification of the cotton gauze enhances HAp and Ag NPs deposition. Chitosan can increase biocompatibility and promotes wound healing properties of cotton gauze. Ag NP deposition onto cotton gauze fabrics brought high antimicrobial activities against Candida albicans, Gram-positive and Gram-negative bacteria, and improved UV protection.