The Washington Times has a two-part interview with Bill Sienkiewicz up, one of those “let’s arrange the quotes in meaty bullet points” things. To wit:
My style evolution: I had an epiphany one day and decided to do whatever I wanted to do on a page, and if they printed it, it would be a valid way to do comics. It was my not-too-subtle way of slipping one past them, and I felt so … clever at 21 years old.
Anyway, it worked. My way of doing comics became legitimate, so it spurred me on to do further experimentation. In Elektra: Assassin, I would tear sheets in half, glue down pieces, sew pieces together, use doilies. If characters needed a Band-Aid, I would use real Band-Aids on their wound. If something looked like it needed to screw into place, I would use a screw. The style caught on, and I thought well, why not?