Chiesa has been ruled out of Italy's World Cup play-off semi-final with Northern Ireland on Thursday in what is a huge blow to Gattuso who immediately called up Nicolò Cambiaghi.
The Italian’s last international appearance came in Euro 2024 and his World Cup chances have taken a hit this week as he withdraws from the camp.
Speaking on Chiesa leaving, Gatusso explained that he wants his players to be 100% and the winger is not at his best at the moment.
“I can’t let my ego get in the way; there’s a lot at stake, so I have to put my lads in the best possible position. We’ll choose the best formation to put the players in the right positions.”
"I have a long chat with Fede every 7 to 10 days. He knows what I think of him, but you have to respect what the player tells you.
“At the moment, he doesn’t feel 100 per cent; he has a few minor issues he needs to work on, and he wants to be 100 per cent fit."
Italy meet Northern Ireland in a semi-final on Thursday and can face either Wales or Bosnia in the final should they keep their World Cup dreams alive.
The four-time winners are hoping to make a World Cup return after failing to qualify for the past two tournaments. Gatusso will hope he can lead his squad there where Chiesa, if fit, could reenter the side.