Sandwich hand draping? I can't even imagine that. The entire hand must be draped in a circumferential manner in order to maintain sterility. If the hand and arm are prepped, then a stockinette should be placed over the hand and all the way up to the axilla. When sterile drapes are placed on the armboard (or hand table), then the draped arm can be lowered, and the surgeon can cut the stockinette to get to the surgical site.
It is accomplished by first laying a drape and towel down with a fold with the arm then set down and another drape placed on top of that and clamped on each side of the arm. The surgeon utilizing it can't believe that we are not familiar and states that all the premier hand surgeons use this technique. The problem is that no one has ever heard of it, so I was checking to see if anyone else had. Thanks!
Your not going to get an answer from nurses who have less than 15 years or so because that draping is really old school. I use to work with a hand surgeon who always used this technique. Never, ever had an infection and I don't see a problem with this.