EX-101 INSTANCE DOCUMENT

Exhibit 10.9

AMENDMENT TO THE

INTEGRA LIFESCIENCES HOLDINGS CORPORATION

SECOND AMENDED AND RESTATED

2003 EQUITY INCENTIVE PLAN

(Effective as of May 17, 2012)

This Amendment (the “Amendment”) to the Integra LifeSciences Holdings Corporation Second Amended and Restated 2003 Equity Incentive Plan (the “Plan”) amends the Plan as follows:

Subsection (b) of Section 8.2 is hereby amended by adding the following sentence to the end thereof:

“Notwithstanding the foregoing, except as otherwise determined by the Committee, in the event of a Participant’s death or Disability, all restrictions on such Participant’s Restricted Stock granted on or after May 17, 2012 (other than Restricted Stock granted to Participants in France) shall lapse and such Restricted Stock shall become vested Shares.”

IN WITNESS WHEREOF, the undersigned, a duly authorized officer of Integra LifeSciences Holdings Corporation, has caused this Amendment to be executed on this 17^th day of May, 2012.