EXECUTION COPY

                                SECOND AMENDMENT


         SECOND AMENDMENT dated as of February 23, 2007 (this "Amendment"),
among INTEGRA LIFESCIENCES HOLDINGS CORPORATION, a Delaware corporation (the
"Borrower"), the lenders party to the Credit Agreement (as defined below)
immediately prior to the effective date of this Amendment (collectively, the
"Existing Lenders"), BANK OF AMERICA, N.A., as Administrative Agent, Swing Line
Lender and L/C Issuer (the "Administrative Agent"), CITIBANK, N.A.,
successor-by-merger to CITIBANK, FSB and SUNTRUST BANK, as Co-Syndication Agents
(the "Co-Syndication Agents"), ROYAL BANK OF CANADA and WACHOVIA BANK, NATIONAL
ASSOCIATION, as Co-Documentation Agents (the "Co-Documentation Agents"),
DEUTSCHE BANK TRUST COMPANY AMERICAS, CIBC INC., GOLDMAN SACHS CREDIT PARTNERS
L.P. AND MORGAN STANLEY BANK (each a "New Lender" and collectively, the
"New Lenders").

         PRELIMINARY STATEMENTS:


         (1)   The Borrower, the Existing Lenders, the Administrative Agent, the
               Co-Syndication Agents and the Co-Documentation Agents have
               entered into a Credit Agreement, dated as of December 22, 2005
               (the "Original Agreement"), as amended by that certain First
               Amendment, dated as of February 15, 2006 (the "First Amendment").
               The Original Agreement, as amended by the First Amendment, is
               referred to in this Amendment as the "Credit Agreement", and the
               Credit Agreement, as amended by, and together with this
               Amendment, and as may be further amended, supplemented or
               otherwise modified from time to time, is referred to herein as
               the "Amended Agreement". Capitalized terms used but not defined
               in this Amendment shall have the meanings assigned to them in the
               Credit Agreement.

         (2)   The Borrower desires to increase the Aggregate Commitments to
               $300,000,000;

         (3)   In connection with such increase, the Borrower has requested that
               each Existing Lender continue its Commitments under the Amended
               Agreement (any Existing Lender that agrees to continue its
               Commitment, a "Continuing Lender" and any Lender that elects not
               to continue its Commitment, a "Terminating Lender") and that New
               Lenders (the New Lenders, together with the Continuing Lenders,
               the "Lenders") make commitments to provide Loans to the extent
               the Commitments of the Continuing Lenders are less than
               $300,000,000;

         (4)   The Borrower has requested the Existing Lenders amend the Credit
               Agreement to (a) increase the Aggregate Commitments to



               $300,000,000 and (b) make the other amendments to the Credit
               Agreement as set forth below.




         NOW, THEREFORE, in consideration of the premises and of the mutual
covenants and agreements contained herein, the parties hereto agree as follows:


         SECTION 1.01. Amendment to Schedule 2.01. Schedule 2.01 of the Credit
Agreement is hereby deleted in its entirety and replaced by Schedule 2.01
attached hereto.

         SECTION 1.02. Amendment to Section 1.01. The definition of "Applicable
Rate" set forth in Section 1.01 of the Credit Agreement is hereby amended by
deleting the pricing grid therefrom and inserting the following pricing grid in
lieu thereof:


              ========================================================================================
                                                    APPLICABLE RATE

              ----------------------------------------------------------------------------------------
                                     Loans, Swing Line Loans and Letters of Credit

              -------------- ------------------- -------------------- ---------------- ---------------

                                                     Eurodollar          Base Rate
                                                        Rate             Loans and
                 Pricing          Pricing         Loans and Letters      Swing Line      Commitment
                  Level            Ratio              of Credit            Loans            Fees
              <s>            <c>                 <c>                  <c>              <c>
              -------------- ------------------- -------------------- ---------------- ---------------
                    I        => 3.25 to 1.0            1.250%              .250%            .20%
              -------------- ------------------- -------------------- ---------------- ---------------
                   II        <3.25 to 1.0 but          1.000%               0%             .175%
                             => 2.50 to 1.0
              -------------- ------------------- -------------------- ---------------- ---------------
                  III        < 2.50 to 1.0 but          .750%               0%              .15%
                             => 1.75 to 1.0
              -------------- ------------------- -------------------- ---------------- ---------------
                   IV        < 1.75 to 1.0 but          .625%               0%             .125%
                             => 1.0 to 1.0
              -------------- ------------------- -------------------- ---------------- ---------------
                    V        < 1.0 to 1.0               .375%               0%              .10%
              ============== =================== ==================== ================ ===============



         SECTION 1.03. Amendment to Section 1.01. The definition of "Maturity
Date" set forth in Section 1.01 of the Credit Agreement is hereby deleted in its
entirety and replaced with the following:

         ""Maturity Date" means December 22, 2011."

         SECTION 1.04. Amendment to Section 1.01. The definition of "Permitted
Acquisitions" set forth in Section 1.01 of the Credit Agreement is hereby
deleted in its entirety and replaced with the following:

                  ""Permitted Acquisitions" means any Acquisition; provided that
                  (a) the Property acquired (or the Property of the Person
                  acquired) in such Acquisition shall be used or useful in the

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                  same or similar line of business as the Loan Parties on the
                  Closing Date, including activities ancillary, related or
                  complementary thereto, (b) after giving effect to any
                  Acquisition on a Pro Forma Basis, the total equity and debt
                  investments of the Borrower and its Domestic Subsidiaries in
                  the Foreign Subsidiaries does not exceed fifty percent (50%)
                  of the aggregate book value of the total assets of the
                  Borrower and its Domestic Subsidiaries, all as determined in
                  accordance with GAAP, (c) in the case of an Acquisition of the
                  Equity Interests of another Person, the board of directors (or
                  other comparable governing body) of such other Person shall
                  have duly approved such Acquisition, (d) no Event of Default
                  has occurred and is continuing or would result therefrom, (e)
                  the Borrower and its Consolidated Subsidiaries shall be in
                  compliance with Section 7.17 on a Pro Forma Basis after giving
                  effect to such Acquisition, (f) the Acquisition shall not
                  involve an interest in a general partnership or joint venture
                  or have a requirement that any Loan Party be a general or
                  joint venture partner other than in compliance with Section
                  7.16, (g) the Loan Parties shall, and shall cause the party
                  that is the subject of the Acquisition to, execute and deliver
                  such joinder and pledge agreements, security agreements and
                  intercompany notes and take such other actions as may be
                  necessary for compliance with the provisions of Sections 6.11
                  and 6.12, (h) if, after giving effect to such Acquisition on a
                  Pro Forma Basis, (1) there will be no Loans outstanding, the
                  aggregate consideration (including cash and non-cash
                  consideration) for each Acquisition (or a series of related
                  Acquisitions) is less than or equal to $250 million or (2)
                  there will be Loans outstanding, the aggregate consideration
                  (including cash and non-cash consideration) for each
                  Acquisition (or a series of related Acquisitions) is less than
                  or equal to (A) $200 million if the Borrower's Consolidated
                  Senior Leverage Ratio is less than 2.00 to 1.00 or (B) $100
                  million if the Borrower's Consolidated Senior Leverage Ratio
                  is greater than or equal to 2.00 to 1.00; provided, that, for
                  purposes of the limits set forth in this clause (h),
                  contingent consideration (i.e., consideration for an
                  Acquisition that is to be paid after the closing of an
                  Acquisition but which at the time of such closing is not
                  numerically quantifiable) shall be added to such limits at the
                  time such consideration first becomes numerically
                  determinable; and (i) the Borrower shall have delivered to the
                  Administrative Agent (1) with respect to any Acquisition in
                  excess of $40 million, a Compliance Certificate signed by a
                  Responsible Officer of the Borrower demonstrating compliance
                  with the financial covenants hereunder after giving effect to
                  the subject Acquisition on a Pro Forma Basis, and reaffirming
                  that the representations are true and correct in all material
                  respects as of such date, except those representations and

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                  warranties made as of a date certain, which shall remain true
                  and correct in all material respects as of such date and
                  providing supplements to the Schedules as required by the
                  Compliance Certificate, (2) with respect to any Acquisition in
                  excess of $75 million, all financial statements for the full
                  fiscal year preceding acquisition, as well as the most recent
                  interim statements of the party that is the subject of the
                  Acquisition, and (3) with respect to any Acquisition in excess
                  of $40 million, within 5 Business Days following the closing
                  of such Acquisition, a certificate of a Responsible Officer of
                  the Borrower describing the Person to be acquired, including,
                  without limitation, the location and type of operations and
                  key management."

         SECTION 1.05. Amendment to Section 1.01. The following definitions are
hereby added to Section 1.01 of the Credit Agreement in appropriate alphabetical
position:

                  "Call Option" means one or more transactions entered into in
connection with a Convertible Note Issue comprised of the purchase by the
Borrower of a call option giving Borrower the right to purchase an amount of its
own issued and outstanding Equity Interests that is equal to the amount of
Equity Interests (or substantially equal to such amount in the event of round
lot purchase requirements) as would be issued if such Indebtedness is converted
(ignoring any net share settlement mechanism pertaining to such Indebtedness),
at an exercise price equal to the conversion price of such Indebtedness.

                  "Convertible Note Issue" means an issuance of Indebtedness or
Equity Interests (other than the Convertible Notes) pursuant to Section 7.03(f),
(h) or (k) that is convertible into Qualified Equity Interests.

         SECTION 1.06. Amendment to Section 2.14. Section 2.14(a) of the Credit
Agreement is hereby deleted in its entirety and replaced with the following:

                  "(a) Request for Increase. Provided there exists no Default or
                  Event of Default, upon notice to the Administrative Agent
                  (which shall promptly notify the Lenders), the Borrower may
                  from time to time, request an increase in the Aggregate
                  Commitments by an aggregate amount (for all such requests) not
                  exceeding $100,000,000; provided that (i) any such request for
                  an increase shall be in a minimum amount of $25,000,000 and
                  (ii) the Borrower may make a maximum of three such requests.
                  At the time of sending such notice, the Borrower (in
                  consultation with the Administrative Agent) shall specify the
                  time period within which each Lender is requested to respond
                  (which shall in no event be less than ten Business Days from
                  the date of delivery of such notice to the Lenders)."

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         SECTION 1.07. Amendment to Section 7.03. Section 7.03(f) of the Credit
Agreement is hereby deleted in its entirety and replaced with the following:

                  "so long as (i) no Event of Default has occurred and is
         continuing or would result therefrom and (ii) the Borrower and its
         Consolidated Subsidiaries shall be in compliance on a Pro Forma Basis
         with Section 7.17 after giving effect to such transaction, subordinated
         Indebtedness that (A) (x) if such subordinated Indebtedness is not a
         public debt issue (which shall include any debt offering made pursuant
         to Rule 144A under the Securities Act of 1933, as amended), is
         expressly subordinated to the Obligations on terms substantially as set
         forth on Exhibit K hereto or otherwise satisfactory to the
         Administrative Agent, and (y) if such subordinated Indebtedness is a
         public debt issue, is expressly subordinated on terms that are
         customary for public subordinated debt transactions at the time of
         issue for companies of similar credit standing and size and has a
         maturity date that is no earlier than the date that is three (3) months
         after the Maturity Date, (B) contains representations, warranties,
         covenants, terms and provisions that are no more restrictive, taken as
         a whole, than those contained in this Agreement, and (C) when added to
         the outstanding amount of the Convertible Notes and any outstanding
         Indebtedness incurred pursuant to clauses (g) and (h) of this Section
         7.03, does not exceed $400 million in the aggregate at any time
         outstanding;"

         SECTION 1.08. Amendment to Section 7.06. Section 7.06(c) of the Credit
Agreement is hereby deleted in its entirety and replaced with the following:

                  "(c) the Borrower may repay the Convertible Notes if either
         (i) after giving pro forma effect to the repayment of the Convertible
         Notes on a Pro Forma Basis, the Consolidated Total Leverage Ratio is
         less than 3.50 to 1.00, or (ii) (A) in the event the Convertible Notes
         remain outstanding on the first day of the RLL Maintenance Period, then
         the Borrower maintains Liquidity of at least $160 million at all times
         during the RLL Maintenance Period until the earlier of (x) the
         expiration of the RLL Maintenance Period and (y) the date the
         Convertible Notes have been repaid or refinanced as permitted hereby
         and (B) after giving effect to any proposed repayment of the
         Convertible Notes, irrespective of when paid, the Borrower has
         Liquidity of at least $40 million;"

         SECTION 1.09. Amendment to Section 7.06. Section 7.06(d) of the Credit
Agreement is hereby deleted in its entirety and replaced with the following:

          "(d)    the Borrower may at any time, and from time to time after the
                  Closing  Date, make Restricted Payments if, after giving
                  effect to such Restricted Payment, (x) there will be no Loans
                  outstanding or (y) there will be Loans outstanding (i)
                  Restricted Payments that do not exceed $50 million in any
                  fiscal year if, at the time of such Restricted Payment, the
                  Borrower's Senior Leverage Ratio is greater than or equal to

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                  2.00 to 1.00 and (ii) Restricted Payments that do not exceed
                  $100 million in any fiscal year if, at the time of such
                  Restricted Payment, the Borrower's Senior Leverage Ratio is
                  less than 2.00 to 1.00; provided, that, it is understood (A)
                  that this Section 7.06(d) does not apply to payments made in
                  respect of the  Convertible Notes, which is governed by the
                  terms of Section 7.06(c) above and (B) that the Borrower may
                  make Restricted Payments in the form of (1) the repurchase,
                  redemption or retirement of any outstanding Equity Interest of
                  the Borrower with the proceeds of subordinated indebtedness,
                  the issuance of which is permitted pursuant to Section
                  7.03(f),  (2) the  withholding,  repurchase, redemption or
                  retirement of any restricted Qualified Equity Interests issued
                  to employees and consultants of the Loan Parties, pursuant to
                  the  Borrower's equity incentive  plans  approved by the
                  Borrower's  Board of  Directors and withheld by the Borrower
                  to satisfy tax obligations of such employees and/or
                  consultants at the time the  forfeiture and transferability
                  restrictions cease, and (3) a purchase of a Call Option in
                  connection with the issuance of Indebtedness permitted
                  pursuant to Section 7.03(f), (h) or (k), in each case of (1),
                 (2) and (3) above,  without  regard to, and without  decreasing
                  the  availability of, the baskets set forth in clauses (y)(i)
                  and (y)(ii) above;"

         SECTION 1.10. Amendment to Section 7.06. Section 7.06(e) of the Credit
Agreement is hereby deleted in its entirety and replaced with the following:

                  "(e) the Borrower may issue or sell (x) Qualified Equity
Interests so long as such issuance or sale does not result in a Change of
Control and (y) other Equity Interests to the extent permitted by Section
7.03(f), (h) or (k);"

         SECTION 1.11. Amendment to Section 7.06. Section 7.06(g) of the Credit
Agreement is hereby deleted in its entirety and replaced with the following:

                  "(g) the Borrower may repurchase or refinance (x) its
outstanding Equity Interests out of the proceeds of a substantially concurrent
issue of, or an exchange for, Qualified Equity Interests and (y) Equity
Interests or Indebtedness issued pursuant to Section 7.03(f) or (k) with the
proceeds of the issuance of Qualified Equity Interests or other Indebtedness
permitted by Section 7.03 (and which complies with the terms of Section
7.03(k));"

         SECTION 1.12. Amendment to Section 7.06. The following new subsections
are hereby added to Section 7.06 of the Credit Agreement:

                 "(h) the Borrower may repurchase or refinance Equity Interests
that evidence Indebtedness issued pursuant to Section 7.03(h);

                  (i) the Borrower may purchase a Call Option in connection with
a Convertible Note Issue and may exercise the Call Option (i) on a cash-less
basis to acquire an equal number of shares (or a substantially equal number in
the event of round lot purchase requirements relating to the Call Option) as are

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issued in connection with any conversion of all or part of the Indebtedness
issued in such Convertible Note Issue by the holders thereof and (ii) as is
provided in Section 7.06(j) below; and

                  (j) the Borrower may exercise a Call Option in connection with
any conversion of all or part of a Convertible Note Issue or may otherwise
redeem, retire or repurchase a Convertible Note Issue in connection with the
conversion of Indebtedness issued pursuant to a Convertible Note Issue in
accordance with its terms and make cash payments in lieu of issuing fractional
shares in connection with such conversion if (i) one or more of the holders of
such Convertible Note Issue elect to convert such Convertible Note Issue on a
net share settlement basis and (ii) after giving effect to the exercise of all
or part of such Call Option or such redemption, retirement or repurchase, as
applicable, on a Pro Forma Basis, (x) the Consolidated Total Leverage Ratio is
less than 3.50 to 1.00 and (y) the Liquidity will be greater than $50 million;
provided, however that in the event the Consolidated Total Leverage Ratio is
greater than 3.50 to 1.00, so long as Liquidity will be greater than $50
million, the Borrower may make Restricted Payments as described in this Section
7.06(j) up to $10 million in the aggregate."

         SECTION 1.13. Amendment to Section 7.07. Section 7.07(e) of the Credit
Agreement is hereby deleted in its entirety and replaced with the following:

                  "(e) Make any prepayment, redemption, defeasance or
acquisition for value (including, without limitation, by way of depositing money
or securities with the trustee with respect thereto before due for the purpose
of paying when due), or refund, refinance or exchange of any subordinated
Indebtedness permitted under Sections 7.03(b), 7.03(f), and 7.03(j) (including
any refinancing thereof pursuant to Section 7.03(k)) other than regularly
scheduled payments of principal and interest on such Indebtedness, refinancings
thereof permitted pursuant to Section 7.03(k) and prepayments of such
Indebtedness with the proceeds of a substantially concurrent issuance of
Qualified Equity Interests; provided, that, the Borrower may (x) repay the
Convertible Notes on the terms set forth in Section 7.06(c) and may exchange the
Convertible Notes in the Convertible Note Exchange and (y) make Restricted
Payments permitted by Section 7.06."

         SECTION 1.14. Amendment to Section 7.09. Section 7.09 of the Credit
Agreement is hereby deleted in its entirety and replaced with the following:

         "Section 7.09 Transactions with Affiliates. Engage in any transaction
or series of transactions with (a) any Subsidiary or Affiliate of the Borrower
or any of its Subsidiaries, or (b) any Affiliate of any such Subsidiary or
Affiliate, whether or not in the ordinary course of business, other than on fair
and reasonable terms substantially as favorable to the Borrower or such
Subsidiary as would be obtainable by the Borrower or such Subsidiary at the time
in a comparable arm's length transaction with a Person other than an Affiliate;
provided, that this Section 7.09 shall not restrict (i) transactions between
Loan Parties, (ii) transactions between Excluded Subsidiaries, (iii)
transactions whereby the Borrower or a Subsidiary provides management or
administrative services to a Subsidiary, (iv) customary indemnities of officers
and directors consistent with Law, payment of reasonable fees to directors and

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the customary issuance of directors' shares, or (v) transactions described in
clauses (a) and (b) above irrespective of whether or not done on an arms-length
basis that do not exceed $750,000 in the aggregate in any calendar year."

         SECTION 1.15. Amendment to Section 7.17. Section 7.17(a) of the Credit
Agreement is hereby deleted in its entirety and replaced with the following:

         "(a)     Maximum Consolidated Total Leverage Ratio. Permit the
                  Consolidated Total Leverage Ratio of the Borrower and its
                  Consolidated Subsidiaries at any time during any period of
                  four consecutive fiscal quarters to be greater than 4.0 to
                  1.0."

         SECTION 1.16. Amendment to Section 7.17. Section 7.17(b) of the Credit
Agreement is hereby deleted in its entirety and replaced with the following:

         "(b)     Maximum Consolidated Senior Leverage Ratio. Permit the
                  Consolidated Senior Leverage Ratio of the Borrower and its
                  Consolidated Subsidiaries at any time during any period of
                  four consecutive fiscal quarters to be greater than 3.0 to
                  1.0."

         SECTION 1.17. Waiver. The Existing Lenders, for the purpose of
effecting the terms of this Second Amendment, hereby (a) waive any notice
requirements under Section 2.05(a) of the Credit Agreement in connection with
the prepayment of the outstanding Loans of the Terminating Lenders, (b) agree
that the outstanding Loans of the Terminating Lenders may be repaid in full,
together with all accrued and unpaid interest thereon and any other amounts
owing with respect thereto, without requiring the repayment of any other Loans
and hereby waive the provisions of Section 2.12(a) and Section 2.13 of the
Credit Agreement to the extent applicable thereto.

         SECTION 1.18. Pay-Off of Terminating Lenders. Exhibit A attached hereto
sets forth the pay-off figures for all Obligations owed to the Terminating
Lenders, including all principal, interest, fees and other amounts owing
(including estimated breakage fees, if any) under the Credit Agreement and the
other Loan Documents as of February 28, 2007 and any per diem figures to the
extent the pay-off occurs after February 28, 2007 (collectively, the "Pay-Off
Amount"). Upon receipt of the Pay-Off Amount in full in cash by the
Administrative Agent for the account of the respective Terminating Lenders, the
Commitments of the Terminating Lenders shall be terminated and all Obligations
of the Borrower in respect of the outstanding Loans held by the Terminating
Lenders shall be paid and discharged in full.

         SECTION 1.19. Representations and Warranties. The Borrower hereby
represents and warrants to the Administrative Agent and the Lenders, as follows:

                  (a) After giving effect to the updated Schedules to the Credit
         Agreement attached to this Amendment as Exhibit B, the representations
         and warranties set forth in Article V of the Credit Agreement and in
         each other Loan Document are true and correct in all material respects
         on and as of the date hereof and on and as of the Second Amendment

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         Effective Date (as defined below) with the same effect as though made
         on and as of the date hereof or the Second Amendment Effective Date, as
         the case may be, except to the extent such representations and
         warranties expressly relate to an earlier date (in which case such
         representations and warranties shall be true and correct in all
         material respects on and as of such earlier date), except that for
         purposes of this Amendment, the representations and warranties
         contained in subsections (a) and (b) of Section 5.05 of the Credit
         Agreement shall be deemed to refer to the most recent statements
         furnished pursuant to subsections (a) and (b), respectively, of Section
         6.01 of the Credit Agreement, including the statements in connection
         with which this Amendment is delivered.

                  (b) On the date hereof and on the Second Amendment Effective
         Date, no Default or Event of Default has occurred and is continuing.

                  (c) The execution, delivery and performance of this Amendment
         by the Borrower have been duly authorized by all requisite corporate or
         other organizational action.

                  (d) This Amendment constitutes the legal, valid and binding
         obligation of the Borrower enforceable against the Borrower in
         accordance with its terms.

         The execution, delivery and performance of this Amendment by the
Borrower do not and will not (i) contravene the terms of any of the Borrower's
Organization Documents; (ii) conflict with or result in any breach or
contravention of, or (except for the Liens created under the Loan Documents) the
creation of any Lien under, or require any payment to be made under (A) any
Contractual Obligation to which the Borrower or the Borrower's Affiliate is a
party or affecting the Borrower or the properties of the Borrower or any of its
subsidiaries or (B) any order, injunction, writ or decree of any Governmental
Authority or any arbitral award to which the Borrower or its property is
subject; or (iii) violate any Law.

         SECTION 1.20. Effectiveness. This Amendment shall become effective only
upon satisfaction of the following conditions precedent (the first date upon
which each such condition has been satisfied being herein called the "Second
Amendment Effective Date"):

                  (a) The Administrative Agent shall have received duly executed
         counterparts of (i) this Amendment which, when taken together, bear the
         authorized signatures of the Borrower, the Lenders and the Terminating
         Lenders and (ii) the Reaffirmation of Guaranty which, when taken
         together, bear the authorized signatures of each Subsidiary Guarantor
         and the Administrative Agent.

                  (b) The Administrative Agent shall have received, for the
         account of the respective Terminating Lenders, the Pay-Off Amount in
         full in cash.

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                  (c) The Borrower shall have prepaid any other Loans
         outstanding (and any additional amounts required pursuant to Section
         3.05 of the Credit Agreement) to the extent necessary to keep the
         outstanding Loans ratable with any revised Applicable Percentages
         arising from any non-ratable increases in the Commitments on the Second
         Amendment Effective Date.

                  (d) The representations and warranties set forth in Section
         1.19 hereof shall be true and correct on and as of the Second Amendment
         Effective Date.

                  (e) The Administrative Agent shall have received all fees and
         expenses required to be paid by the Borrower pursuant to Section 1.23
         of this Amendment.

                  (f) The Lenders shall have received such other documents,
         legal opinions, instruments and certificates as they shall reasonably
         request and such other documents, legal opinions, instruments and
         certificates shall be satisfactory in form and substance to the Lenders
         and their counsel. All corporate and other proceedings taken or to be
         taken in connection with this Amendment and all documents incidental
         thereto, whether or not referred to herein, shall be satisfactory in
         form and substance to the Lenders and their counsel.

         SECTION 1.21. Joinder of New Lenders. (a) Each New Lender, intending to
be legally bound, hereby joins and becomes a "Lender" under the Credit
Agreement, effective as of the Second Amendment Effective Date, and shall be
entitled to the benefits, rights, privileges and remedies of a Lender under the
Credit Agreement and each of the other Loan Documents as of the Second Amendment
Effective Date.

                  (b) Each New Lender (i) represents and warrants that (A) it
         has full power and authority, and has taken all action necessary, to
         execute and deliver this Amendment and to consummate the transactions
         contemplated hereby and to become a Lender under the Credit Agreement,
         (B) it meets all requirements of an Eligible Assignee under the Credit
         Agreement (subject to receipt of such consents as may be required under
         the Credit Agreement), (C) from and after the Second Amendment
         Effective Date, it shall be bound by the provisions of the Credit
         Agreement and shall have the obligations of a Lender thereunder, (D) it
         has received a copy of the Credit Agreement, together with copies of
         the most recent financial statements delivered pursuant to Section 6.01
         thereof, as applicable, and such other documents and information as it
         has deemed appropriate to make its own credit analysis and decision to
         enter into this Amendment and to make its Commitment on the basis of
         which it has made such analysis and decision independently and without
         reliance on the Administrative Agent or any other Lender, and (E) if it
         is a Foreign Lender, attached hereto is any documentation required to
         be delivered by it pursuant to the terms of the Credit Agreement, duly
         completed and executed by such New Lender; (ii) agrees that (A) it
         will, independently and without reliance on the Administrative Agent or
         any Lender, and based on such documents and information as it shall
         deem appropriate at the time, continue to make its own credit decisions
         in taking or not taking action under the Loan Documents, and (B) it

                                       10


         will perform in accordance with their terms all of the obligations
         which by the terms of the Loan Documents are required to be performed
         by it as a Lender; and (iii) specifies as its address for notices the
         office designated in its Administrative Questionnaire provided to the
         Administrative Agent.

         SECTION 1.22. APPLICABLE LAW. THIS AMENDMENT SHALL BE GOVERNED BY, AND
CONSTRUED IN ACCORDANCE WITH, THE LAW OF THE STATE OF NEW YORK WITHOUT REFERENCE
TO THE CONFLICTS OF LAWS PRINCIPLES THEREOF.

         SECTION 1.23. Fees and Expenses. (a) The Borrower shall pay all
applicable fees and expenses as set forth in the Letter Agreement, dated as of
February 21, 2007, between the Borrower, Bank of America, N.A. and Banc of
America Securities LLC.

                  (b) The Borrower shall pay all reasonable out-of-pocket
         expenses incurred by the Administrative Agent in connection with the
         preparation, negotiation, execution, delivery and enforcement of this
         Amendment, including, but not limited to, the reasonable fees and
         disbursements of counsel.

         SECTION 1.24. Lender Titles. From and after the Second Amendment
Effective Date, (a) Citibank, N.A. shall be the Syndication Agent and (b)
JPMorgan Chase Bank, N.A., Deutsche Bank Trust Company Americas and Royal Bank
of Canada shall be the Co-Documentation Agents.

         SECTION 1.25. Counterparts. This Amendment may be executed in any
number of counterparts, each of which shall constitute an original but all of
which when taken together shall constitute but one agreement. Delivery by
facsimile by any of the parities hereto of an executed counterpart of this
Amendment shall be as effective as an original executed counterpart hereof and
shall be deemed a representation that an original executed counterpart hereof
will be delivered, but the failure to deliver a manually executed counterpart
shall not affect the validity, enforceability or binding effect of this
Amendment.

         SECTION 1.26. Credit Agreement. Except as expressly set forth herein,
the amendments provided herein shall not by implication or otherwise limit,
constitute a waiver of, or otherwise affect the rights and remedies of the
Lenders or the Administrative Agent under the Credit Agreement or any other Loan
Document, nor shall they constitute a waiver of any Default or Event of Default,
nor shall they alter, modify, amend or in any way affect any of the terms,
conditions, obligations, covenants or agreements contained in the Credit
Agreement or any other Loan Document. Each of the amendments provided herein
shall apply and be effective only with respect to the provisions of the Credit
Agreement specifically referred to by such amendment. Except as expressly
amended herein, the Credit Agreement shall continue in full force and effect in
accordance with the provisions thereof. As used in the Credit Agreement, the
terms "Agreement", "herein", "hereinafter", "hereunder", "hereto" and words of

                                       11


similar import shall include, from and after the Second Amendment Effective
Date, the Amended Agreement.


                                       12



         IN WITNESS WHEREOF, the parties hereto have caused this Amendment to be
duly executed by their duly authorized officers, all as of the date first above
written.


                                            Borrower:


                                            INTEGRA LIFESCIENCES HOLDINGS
                                            CORPORATION, a Delaware corporation


                                            By:/s/ Maureen B. Bellantoni
                                               --------------------------------
                                               Name: Maureen B. Bellantoni
                                               Title: Executive Vice President
                                                    and Chief Financial Officer









                                            BANK OF AMERICA, N.A., as
                                            Administrative Agent


                                            By:/s/ Amie L. Edwards
                                               --------------------------------
                                               Name:  Amie L. Edwards
                                               Title: Vice President


                                            BANK OF AMERICA, N.A., as Swing Line
                                            Lender, L/C Issuer and as a Lender


                                            By:/s/ Amie L. Edwards
                                               --------------------------------
                                               Name:  Amie L. Edwards
                                               Title: Vice President






                                            CITIBANK, N.A., successor-by-merger
                                            to CITIBANK, FSB, as Co-Syndication
                                            Agent and as a Lender


                                            By:/s/ Christopher D. Pannacciulli
                                               --------------------------------
                                               Name: Christopher D. Pannacciulli
                                               Title: Vice President







                                            SUNTRUST BANK, as Co-Syndication
                                            Agent and as a Lender


                                            By:/s/ Helen C. Hartz
                                               --------------------------------
                                               Name: Helen C. Hartz
                                               Title: Vice President







                                            ROYAL BANK OF CANADA, as Co-
                                            Documentation Agent and as a Lender


                                            By:/s/ Gordon MacArthur
                                               --------------------------------
                                               Name: Gordon MacArthur
                                               Title: Authorized Signatory








                                            WACHOVIA BANK, NATIONAL ASSOCIATION,
                                            as Co-Documentation Agent and as
                                            a Lender


                                            By:/s/ James S. Conville
                                               --------------------------------
                                               Name: James S. Conville
                                               Title: Assistant Vice President







                                            CITIZENS BANK PA, as a Lender


                                            By:/s/ Mark W. Torie
                                               --------------------------------
                                               Name: Mark W. Torie
                                               Title: Senior Vice President






                                            SOVEREIGN BANK, as a Lender


                                            By:/s/ Chris D. Wolfslayer
                                               --------------------------------
                                               Name: Chris D. Wolfslayer
                                               Title: Vice President







                                            DRESDNER BANK AG, NEW YORK AND GRAND
                                            CAYMAN BRANCHES, as a Lender


                                            By:/s/ Brian Smith
                                               --------------------------------
                                                 Name: Brian Smith
                                                 Title: Managing Director



                                            By:/s/ Mark McGuigan
                                               --------------------------------
                                                 Name: Mark McGuigan
                                                 Title: Vice President






                                            HSBC BANK USA, NATIONAL ASSOCIATION,
                                            as a Lender


                                            By:/s/ Jeffrey Wieser
                                               --------------------------------
                                               Name: Jeffrey Wieser
                                               Title: Managing Director






                                            COMMERCE BANK, N.A., as a Lender


                                            By:/s/ Daniel R. Vereb
                                               --------------------------------
                                               Name: Daniel R. Vereb
                                               Title: Vice President






                                            PEOPLE'S BANK, as a Lender


                                            By:/s/ George F. Paik
                                               --------------------------------
                                               Name: George F. Paik
                                               Title: Vice President






                                            BROWN BROTHERS HARRIMAN & CO, as a
                                            Lender


                                            By:/s/ John D. Rogers
                                               --------------------------------
                                               Name: John D. Rogers
                                               Title: Senior Vice President






                                            COMERICA BANK, as a Lender


                                            By:/s/ Mark R. Pierzecki
                                               --------------------------------
                                               Name: Mark R. Pierzecki
                                               Title: Vice President







                                            PNC BANK NATIONAL ASSOCIATION, as a
                                            Lender


                                            By:/s/ Sharon Landgraf
                                               --------------------------------
                                               Name: Sharon Landgraf
                                               Title: Vice President







                                            JPMORGAN CHASE BANK, N.A., as a
                                            Lender


                                            By:/s/ Dawn B. Scocco
                                               --------------------------------
                                               Name: Dawn B. Scocco
                                               Title: Associate







                                            DEUTSCHE BANK TRUST COMPANY
                                            AMERICAS, as a New Lender


                                            By:/s/ Carin Keegan
                                               --------------------------------
                                               Name: Carin Keegan
                                               Title: Vice President


                                            By:/s/ Omayra Laucella
                                               --------------------------------
                                               Name: Omayra Laucella
                                               Title: Vice President






                                            MORGAN STANLEY BANK, as a New Lender


                                            By:/s/ Daniel Twenge
                                               --------------------------------
                                               Name: Daniel Twenge
                                               Title: Authorized Signatory
                                                      Morgan Stanley Bank






                                            CIBC INC., as a New Lender


                                            By:/s/ Caroline Weldon
                                               --------------------------------
                                               Name: Caroline Weldon
                                               Title: Authorized Signatory







                                            GOLDMAN SACHS CREDIT PARTNERS L.P.,
                                            as a New Lender


                                            By:/s/ Mark Walton
                                               --------------------------------
                                               Name: Mark Walton
                                               Title: Authorized Signatory











                                                                   SCHEDULE 2.01

                                   COMMITMENTS
                           AND APPLICABLE PERCENTAGES



                                                                   Applicable
            Lender                          Commitment             Percentage
- --------------------------------------------------------------------------------
<s>                                       <c>                      <c>
Bank of America, N.A.                     $30,000,000.00           10.000000000%

Citibank, N.A.                            $30,000,000.00           10.000000000%

JPMorgan Chase Bank, NA                   $30,000,000.00           10.000000000%

Royal Bank of Canada                      $30,000,000.00           10.000000000%

Deutsche Bank Trust Company Americas      $30,000,000.00           10.000000000%

Wachovia Bank, National Association       $20,000,000.00            6.666666667%

Citizens Bank PA                          $20,000,000.00            6.666666667%

PNC Bank National Association             $20,000,000.00            6.666666667%

HSBC Bank USA, National Association       $15,000,000.00            5.000000000%

Commerce Bank, N.A.                       $15,000,000.00            5.000000000%

People's Bank                             $15,000,000.00            5.000000000%

Morgan Stanley Bank                       $12,500,000.00            4.166666667%

Goldman Sachs Credit Partners L.P.        $12,500,000.00            4.166666667%

Brown Brothers Harriman & Co              $10,000,000.00            3.333333333%

CIBC Inc.                                 $10,000,000.00            3.333333333%


TOTAL                                    $300,000,000.00          100.000000000%