As it grew to be the largest neurosurgery company, worth more than $1 billion in market capitalization, Integra developed many new products and bought many more.

“Stuart Essig recognized that collagen itself will not build a company, so he purchased neurosurgical companies and made it much more successful,” says Joe Nichols, who founded one of the firms from which Integra evolved. “He had the connections with the wheelers and dealers on Wall Street to make it work.”

Debbie Leonetti, senior vice president of marketing and a registered nurse, emphasizes the vitality of Integra’s corporate culture, where change is a driving force. “Integra is an environment where you can become an entrepreneur inside the company,” she says. When anyone asks her what keeps her at Integra, she tells them: “Every three months I have a new product to figure out how to do the marketing, positioning, pricing, and presentation to customers.”

During Leonetti’s tenure, about the same as CEO Essig’s, she has seen about 30 acquisitions, in addition to internally developed products.

Integra has two types of revenues: neurosurgical and orthopedic implants and medical surgical equipment.

The neurosurgical and orthopedic implants include dural grafts for the repair of the dura matter, dermal regeneration and engineered wound dressings, implants used in small bone and joint fixation, repair of peripheral nerves, and hydrocephalus management, and implants used in bone regeneration and in guided tissue regeneration in periodontal surgery.

The medical surgical equipment product group includes ultrasonic surgery systems for tissue ablation, cranial stabilization and brain retraction systems, and instrumentation used in general, neurosurgical, spinal and plastic and reconstructive surgery and dental procedures. It also supplies collagen and other absorbable matrices for Wyeth’s bone regeneration applications.

This year, so far, Integra or its subsidiaries have bought these products:

DenLite, a lighted mouth mirror used in dental procedures. Price: about $2.5 million.

Radionics, a Burlington, Massachusetts-based division of Tyco Healthcare Group. The firm designs, makes, and sells minimally invasive medical instruments, such as an ultrasonic surgical aspiration system, and an image-guided surgery system. Price: $7.7 million.

Physician Industries’ pain management business. Based in Salt Lake City, Utah, it assembles, markets, and sells products for spinal, epidural, nerve block, and biopsy procedures. Price: $4 million.

Last year Integra launched a new regenerative technology implant, the Mozaik Osteoconductive Scaffold, and a new monitoring system for neurosurgeons. It spent more than $220 million to buy four businesses:

Miltex Holdings, a distributor of surgical and dental hand instruments to doctors’ and dentists offices. Based in York, Pennsylvania it had an office in Tuttlingen, Germany, which has been closed. Price: $103 million.

Canada Microsurgical, for a direct sales force. Price: $5.9 million.

Kinetikos Medical, a developer and maker of orthopedic implants and surgical devices deformities and arthritis in the small bone and joints (the foot, ankle, hand, wrist and elbow). Price: $39.5 million.

LXU Healthcare Inc., a Massachusetts-based maker of fiber optic headlight systems for 50,000 surgeons worldwide. Its LXU Medical division distributes surgical products and has a sales force covering 18,000 operating rooms in the southeastern, midwestern and mid-Atlantic United States. Another division distributed critical care products in the southeastern U.S. Price: $30 million.

Acquisitions In 2005:

Eunoe Inc.’s shunt system for Alzheimer’s disease patients. This system is similar to Integra’s own treatment for hydrocephalus.

Newdeal Technologies, a Lyon, France-based maker of implants and instruments for foot and ankle surgery. Price: just over $52 million.

Acquisitions in 2004:

R&B Surgical Solutions’ instrument business, for neuro and spinal surgery. Price: $2 million.

Fleetwood Medical’s Sparta disposable critical care devices and surgical instruments business for plastic and reconstructive, ear, nose and throat (ENT), neuro, ophthalmic and general surgery. Price: $1.6 million.

Schaerer Mayfield’s cranial stabilization systems and halo retractor system, including skull clamps, headrests, reusable and disposable skull pins, blades, retractor systems, and spinal implants. Price: $20.6 million.

Berchtold Medizin-Elektronik GmbH, a maker of electrosurgery generators, an ultrasonic surgical aspirator, and related instruments. Price: $5 million.

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Regeneration products, containing material derived from bovine tissue, constituted 24 percent and 31 percent of total revenues in each of the three-month periods ending March 31, 2007 and 2006. They include the DuraGen and NeuraGen product families and the Integra dermal regeneration template and wound dressing products.

Integra has an international footprint. It has plants in Puerto Rico, France, Germany, Ireland and the United Kingdom. For the first quarter of this year, 26 percent of the revenues came from outside the United States, and the majority (63 percent) came from Europe.

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