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                                AMENDMENT 2006-1
                                     TO THE
                SECOND AMENDED AND RESTATED EMPLOYMENT AGREEMENT

         AMENDMENT, dated as of December 19, 2006, between Integra LifeSciences
Holdings Corporation, a Delaware corporation (the "Company") and Stuart M. Essig
(the "Executive").

                                    RECITALS

         WHEREAS, the Company and Executive previously entered into the Second
Amended and Restated Employment Agreement, dated as of July 27, 2004, (the
"Employment Agreement"), that sets forth the terms and conditions of Executive's
employment with the Company, including, but not limited to, severance benefits
that will be payable to Executive if he experiences a covered termination;

         WHEREAS, the Company and Executive desire to amend the Employment
Agreement to provide certain severance benefits to Executive in the event
Executive's employment is terminated by the Company for a covered termination in
connection with a Change in Control (as defined in the Employment Agreement);
and

         WHEREAS, Section 8.6 of the Employment Agreement provides that the
Employment Agreement may be amended pursuant to a written agreement between
Executive and the Company.

         NOW, THEREFORE, the Company and Executive hereby agree that, effective
December 19, 2006, the Employment Agreement shall be amended as follows:

         1.       The heading of Section 4.4 of the Employment Agreement is
hereby amended in its entirety to read as follows:

                  "4.4 Termination without Cause or by Executive for Good Reason
Unrelated to a Change in Control."

         2.       The first sentence of Section 4.4(a) of the Employment
Agreement shall be amended in its entirety to read as follows:

                  "Except as provided in Section 6.2 in the event of a Change in
                  Control (as defined in Section 6.1), if (i) Executive's
                  employment is terminated by the Company for any reason other
                  than Cause or the death or Disability Termination of
                  Executive, or (ii) Executive's employment is terminated by
                  Executive for Good Reason (as defined herein), then (A) the
                  Company shall pay to Executive a lump sum cash payment equal
                  to the sum of (x) the Accrued Obligations and (y) his Base
                  Salary (including the minimum increases provided therein)
                  during the remainder of the then-current Term, (B) all Stock
                  Options granted to Executive shall become immediately vested
                  (to the extent not already vested) on the date of such
                  termination and shall be exercisable through their original
                  expiration dates, and (C) all Additional Unit Shares shall be
                  delivered to Executive as provided in his Restricted Units
                  Agreement, as amended."





         3.       Section 4.4(b) of the Employment Agreement is hereby amended
by adding the following paragraph at the end thereof:

                  "Notwithstanding anything contained herein to the contrary,
                  "Good Reason" shall also mean if, following a Change in
                  Control, Executive is not the Chief Executive Officer of the
                  ultimate parent entity which directly or indirectly, through
                  one or more subsidiaries, controls, through equity ownership,
                  board representation or otherwise, the operation of the
                  business that was conducted by the Company prior to the Change
                  in Control, it being understood that the ultimate parent
                  entity following a Change in Control is the top tier entity in
                  the chain of entities directly or indirectly controlling the
                  operation of the Company's business following a Change in
                  Control and such entity may be the Company, an acquiring or
                  successor entity or an affiliate of an acquiring or successor
                  entity. No notice requirement or remedial period is applicable
                  if Executive elects to terminate his employment on account of
                  a Good Reason termination pursuant to the immediately
                  preceding sentence following a Change in Control; provided,
                  however, that this paragraph shall only be effective for the
                  eighteen (18) month period following a Change in Control."

         4.       Section 4.5 of the Employment Agreement is hereby amended in
its entirety to read as follows:

                  "4.5 Failure to Extend. Except as otherwise provided in
                  Section 6.2 below, in the event that Executive's employment
                  with the Company terminates due to a failure by either party
                  to extend this Agreement pursuant to Section 2.1, the Company
                  shall not thereafter be obligated to make any further payments
                  hereunder other than Accrued Obligations and Executive shall
                  be eligible to elect COBRA continuation coverage, at his
                  expense, with respect to any Health Benefits COBRA
                  continuation coverage is legally required to be offered to
                  Executive. In the event that Executive's employment with the
                  Company terminates upon expiration of the Term because the
                  Company provides Executive with notice of termination pursuant
                  to Section 2.1, then, in addition to the foregoing, each
                  Additional Company Stock Option outstanding as of such date
                  shall fully vest (to the extent not already vested) and shall
                  remain exercisable until the expiration date of such
                  Additional Company Stock Option (e.g., 10 years after the
                  grant date or such lesser time as is specified in the
                  Additional Company Stock Option grant)."

         5. Current Section 6.2 of the Employment Agreement, and all references
to current Section 6.2 of the Employment Agreement, are hereby renumbered as
Section 6.3, and a new Section 6.2 is hereby added to the Employment Agreement
to read as follows:

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                  "6.2 Termination without Cause or by Executive for Good Reason
                  Related to a Change in Control. Notwithstanding anything to
                  the contrary set forth in Section 4.4(a) above, and subject to
                  Executive and the Company executing a mutual release that is
                  mutually agreeable (provided, however, that Executive shall
                  not be required to execute such mutual release as a condition
                  to the receipt of the payments and benefits described below
                  unless the Company also executes such mutual release), in the
                  event that within 18 months following a Change in Control: (i)
                  the Company fails to extend this Agreement pursuant to Section
                  2.1, (ii) Executive terminates his employment for Good Reason
                  or (iii) Executive's employment is terminated by the Company
                  for a reason other than death, Disability Termination or
                  Cause, then the Company shall:

                           (a) pay Executive an amount equal to the Accrued
                  Obligations, excluding any bonus accruals;

                           (b) pay Executive a severance amount equal to the sum
                  of (i) 2.99 times the amount that results from adding
                  Executive's Base Salary (determined prior to any reduction
                  that would provide Executive with the right to terminate his
                  employment on account of Good Reason) as of his last day of
                  active employment to the target bonus that Executive was
                  eligible to receive in the fiscal year of his termination of
                  employment, and (ii) a pro ration of the target bonus that
                  Executive was eligible to receive in the fiscal year of his
                  termination of employment, with such pro ration determined by
                  multiplying such target bonus amount by a fraction, the
                  numerator of which is the number of days during which
                  Executive was employed by the Company in the fiscal year of
                  his termination and the denominator of which is 365; except as
                  provided below, the severance amount shall be paid in a single
                  sum on the first business day of the month following the Date
                  of Termination (or, if later, the first business day of the
                  month following the date on which Executive may revoke the
                  mutual release);

                           (c) maintain and provide to Executive, at no cost to
                  Executive, for a period ending on the later of (i) the end of
                  the Term of the Agreement or (ii) one year following
                  Executive's Date of Termination, continued participation in
                  the Health Benefits and life insurance programs in which
                  Executive, his spouse and his eligible dependents were
                  participating immediately prior to the date of such
                  termination at the level in effect and upon substantially the
                  same terms and conditions (including without limitation
                  contributions required by Executive for such benefits) as
                  existed immediately prior to the date of termination;
                  provided, that if Executive, his spouse or his eligible
                  dependents cannot continue to participate in the Company
                  programs providing such benefits, the Company shall pay or
                  reimburse the premiums for a health care program for
                  Executive, his spouse and his eligible dependents that is
                  substantially equivalent to the then-current Health Benefits;
                  but further provided, that such Health Benefits shall
                  terminate upon the date or dates Executive receives equivalent
                  coverage and benefits that do not include waiting period or
                  pre-existing condition limitations, under the plans and
                  programs of a subsequent employer (such coverage and benefits
                  to be determined on a coverage-by-coverage or
                  benefit-by-benefit basis). If such coverage is provided under

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                  the Company programs, then upon termination of such coverage,
                  Executive and his dependents shall be afforded Health Benefits
                  continuation rights in accordance with COBRA; and

                           (d) pay to Executive all reasonable legal fees and
                  expenses incurred by Executive as a result of such termination
                  of employment (including all legal fees and expenses, if any,
                  incurred by Executive in contesting or disputing any such
                  termination or in seeking to obtain or enforce any right or
                  benefit provided to Executive by this Agreement whether by
                  arbitration or otherwise).

                  Notwithstanding anything in the foregoing to the contrary, if
                  any of the foregoing severance amounts are deemed as deferred
                  compensation subject to the requirements of section 409A of
                  the Internal Revenue Code of 1986, as amended (the "Code"),
                  the Company shall pay such severance amounts in accordance
                  with the requirements of section 409A of the Code, which may
                  include, among other requirements, deferring the payment of
                  the severance benefits to a date that is no sooner than then
                  after the six month period following Executive's Date of
                  Termination; provided, however, that if such payment is
                  delayed it shall be paid as soon as administratively
                  practicable following the expiration of such six month period,
                  but not later then the first Company payroll date that occurs
                  after the end of such six month period. If any of the
                  severance payments are deferred due to such requirements,
                  there shall be added to such payments interest during the
                  deferral period at a rate, per annum, equal to the applicable
                  federal short-term rate (compounded monthly) in effect under
                  Section 1274(d) of the Code on the Executive's Date of
                  Termination."

         6. In all respects not modified by this Amendment 2006-1, the
Employment Agreement is hereby ratified and confirmed.

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         IN WITNESS WHEREOF, the Company and Executive agree to the terms of the
foregoing Amendment 2006-1, effective as of the date set forth above.



                                               INTEGRA LIFESCIENCES
                                               HOLDINGS CORPORATION

                                               By:/s/ Richard E. Caruso
                                                  ---------------------
                                               Name: Richard E. Caruso
                                               Title: Chairman


                                               EXECUTIVE
                                               /s/ Stuart M. Essig
                                               ------------------------
                                               Stuart M. Essig

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