In the operating room, there are many supplies that are opened BEFORE the surgeon actually needs them.  This includes implants (patch materials, etc) and sutures.  The scrub nurses try to "stay ahead" but the could stll stay ahead if they would open things more "on demand" rather than in batches which results in tremendous waste.  I understand their desire to make sure they have everything just when the surgeons need it, but with better communication between the surgeons and their scrubs and a conscious effort to avoid opening too much product and once, we can have a significang impact on reducing wasted expensive materials.