From Team Fortress Wiki
Thank you doctor!
— The Heavy thanking the Medic for arm reattachment
The Soviet Stitch-Up is a miscellaneous item for the Heavy. It is a pair of large bolts in the sides of the Heavy's neck and team-colored gashes on both of his arms held shut with tape.
This item can only be worn around Halloween or during a Full Moon; at other times of the year, it does not appear in gameplay, unless the server has Halloween mode enabled. However, it can be equipped at any time and can still be viewed on the loadout screen even when it is not visible during games.
October 27, 2011 Patch (Very Scary Halloween Special)
- The Soviet Stitch-Up was added to the game.