The New Zealander made only one unenforced switch, bringing in Rhys Webb for Gareth Davies at scrum-half.
Sam Warburton, Alun Wyn Jones and Alex Cuthbert miss out with injuries.
"We wanted to give the players a chance to sort of put behind us a disappointing first half from last week," said Gatland.
Flanker Justin Tipuric, second row Luke Charteris and Hallam Amos are drafted in to the team in place of the injured players.
Dan Lydiate will captain the side in the absence of Warburton and regular stand-in Jones.
Gatland said he had shown faith in players who had performed well in earlier matches, a fact he acknowledged was hard on hooker Ken Owens who makes his fourth appearance on the bench in this Six Nations championship.
"He's unlucky, really unlucky," he added.
"We felt that [hooker] Scott Baldwin has gone pretty well throughout the campaign.
"Ken has been brilliant for us coming off the bench and I know that's a tag he doesn't want to keep, but he is unlucky not to get a start."
Scarlets hooker Owens had made 38 appearances for Wales, but started in only eight of those games.
Wales go into the match against Italy knowing a win will secure second place in the championship for the first time since it was expended to include six countries.
Lydiate will lead Wales for the first time in a Test match, having previously led them in a midweek match against EP Kings on the summer tour of South Africa in 2014.
He said it was a "personal honour for me and my family" and added his captaincy style was unsophisticated.
"I wouldn't ask someone to do something that I wouldn't do myself, so I'll throw myself in front of a bus so that's what I expect everyone else to do," he said.
"There are plenty of leaders and a wealth of experience in the team."

Wilson, 37, and from Sheffield, was struck by flying debris and suffered head injuries during the Pocono IndyCar 500 race in Pennsylvania on 23 August.
About 500 people attended the seven-time IndyCar race winner's funeral at Paulerspury in Northamptonshire.
The family, friends and colleagues joined Wilson's widow Julia at Silverstone afterwards.
Ex-Formula 1 driver Mark Webber and retired IndyCar racer Dario Franchitti were among the pallbearers.
Webber said: "It was an honour for me to do that for the family because we are a family in many ways when it comes to motorsport.
"We know the dangers are always there. Motorsport has had good and bad patches when it comes to these tragic events and when it is really close to home then it hits you even harder.
"You think of the family and everyone who is going to be affected by this. Motorsport is a tight-knit family and when we need to get together in really tough times we do our best."
Jonathan Palmer, the former F1 driver who took Wilson on as a protÃ©gÃ©, and former F1 champion Sir Jackie Stewart also attended.
Palmer, who read an 11-minute eulogy in his honour, said: "Justin was the innocent victim in a cruel twist of fate when he was hit by flying debris from an incident ahead. It still feels like a bad dream but tragically it is only too real."
The father of two died a day after Sage Karam's car spun and crashed in front of him on lap 179 of 200.
Wilson's major motorsport breakthrough came in F1.
He won the Formula 3000 series in 2001, and two years later raised Â£1.2m to finance his F1 entry after setting up a company in his own name.
Wilson scored his only point from 16 races with Minardi and Jaguar during 2003 at the United States Grand Prix.
He moved to the US in 2004 and enjoyed greater success in Champ Car, finishing as series runner-up in 2006 and 2007 before switching to IndyCar racing in 2008, after Champ Car merged with the Indy Racing League.
He finished second in the previous IndyCar race in Mid-Ohio on 2 August, his first podium finish since 2013, while his final victory came at the Firestone 550 at Texas Motor Speedway in June 2012.
Mark Miles, chief executive of IndyCar parent company Hulman & Co, paid tribute to Wilson's "elite ability" and his "unwavering kindness, character and humility".
Wales coach Warren Gatland resisted making more changes to his team against Italy to give his men a chance to make up for their poor start at Twickenham.
[NEXT_CONCEPT]
The funeral has taken place of British IndyCar driver Justin Wilson, who died during a race last month in America.