EXHIBIT 10.9

                                                                  EXECUTION COPY

                   FIRST AMENDMENT TO THE AMENDED AND RESTATED
                           LOAN AND SECURITY AGREEMENT


     FIRST  AMENDMENT,  dated as of August 31, 2001 (this  "Amendment"),  to the
Amended and Restated Loan and Security Agreement,  dated as of March 2, 2001 (as
amended,  supplemented,  or otherwise  modified  from time to time,  the "Credit
Agreement"),  among PRIMESOURCE  HEALTHCARE,  INC., f/k/a LUXTEC CORPORATION,  a
Massachusetts  corporation (the  "Borrower"),  the guarantors party thereto (the
"Guarantors"),  and ARK CLO 2000-1,  LIMITED,  a Cayman Islands exempted company
(the "Lender").

                              W I T N E S S E T H:

     WHEREAS,  the  Borrower,  Guarantors  and Lender are  parties to the Credit
Agreement;

     WHEREAS,  pursuant  to a waiver  letter  dated June 28,  2001 (the  "Waiver
Letter"), the Lender waived certain Acknowledged Events of Default (as that term
is defined in the Waiver Letter) under the Credit  Agreement which have occurred
during the period from March 2, 2001 through June 30, 2001;

     WHEREAS,  the Borrower and Guarantors  have requested that the Lender amend
the Credit Agreement as set forth herein;

     WHEREAS,  the Lender is willing  to agree to such  amendment  to the Credit
Agreement, subject to the terms and conditions set forth herein;

     NOW,  THEREFORE,  in  consideration  of the premises  and mutual  covenants
contained herein and other good and valuable consideration,  the sufficiency and
receipt of which are hereby acknowledged, the parties hereto agree as follows:

     1. DEFINED TERMS.  Capitalized  terms used herein and not otherwise defined
herein shall have the respective meanings given to them in the Credit Agreement.

     2. AMENDMENTS TO CREDIT  AGREEMENT.  The Credit Agreement is hereby amended
as follows:

          (a) AMENDMENT OF SECTION 1.01.


               (i) The definition of "CURRENT LIABILITIES"  contained in Section
          1.01 of the Credit Agreement is hereby replaced with the following:


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               "CURRENT  LIABILITIES":   means  all  accounts  payable  and  all
               accruals of the Borrower and the  Guarantors,  on a  consolidated
               basis.

               (ii) The  definition of "NET WORTH"  contained in Section 1.01 of
          the Credit Agreement is hereby replaced with the following:

               "Net Worth":  means  $2,000,000 plus the cumulative  consolidated
               net income or net loss of the  Borrower and the  Guarantors  from
               March 1, 2001 to the date of determination plus the net amount of
               the  proceeds  from  the  issuance  of any new  capital  stock of
               Borrower, which proceeds are received by the Borrower and are not
               contributed or otherwise distributed,  disposed of or transferred
               to another Person.

          (b) AMENDMENT OF SECTION 6.01. Section 6.01 of the Credit Agreement is
     hereby amended as follows:



               (i)  Section  6.01(f)  of the  Credit  Agreement  is  amended  by
          deleting it in its entirety and substituting therefor the following:

               (f) The ratio of (a) the Borrower's Total  Liabilities to (b) Net
               Worth shall, for the three month period ending on the last day of
               each quarter  indicated below, be equal to or less than the ratio
               indicated:


Three Month Period Ending
on the Following Quarter Ends                                Ratio
-----------------------------                                -----

September 30, 2001                                           2.50 to 1

December 31, 2001                                            2.25 to 1

Each quarter end thereafter                                  2.00 to 1



               (i)  Section  6.01(i)  of the  Credit  Agreement  is  amended  by
          deleting it in its entirety and substituting therefor the following:

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<PAGE>

               (i)  The  ratio  of the  Borrower's  Current  Assets  to  Current
               Liabilities  shall, for the three month period ending on the last
               day of each quarter  indicated  below,  be equal to or exceed the
               ratio indicated:


Three Month Period Ending
on the Following Quarter Ends                                Ratio
-----------------------------                                -----

September 30, 2001                                           0.90

December 31, 2001                                            0.95

Each quarter end thereafter                                  1.00


          (a) AMENDMENT OF SECTION 6.02. Section 6.02 of the Credit Agreement is
     hereby amended by adding the following new subsections (u) after subsection
     (t) therein to read as follows:

               (u)  Neither  the  Borrower  nor any  Guarantor  shall  make  any
               contributions,  including but not limited to contributions of any
               proceeds  from  the  sale or  issuance  of new  capital  stock of
               Borrower or Guarantor,  to any  Subsidiary or other  Affiliate of
               Borrower or any Guarantor  without the prior  written  consent of
               the  Lender,  the  granting  of  which  consent  shall  be in the
               Lender's sole discretion.

     2.  Effectiveness.  This Amendment shall become effective as of the date of
receipt by the Lender of (a)  counterparts  of this  Amendment  executed  by the
Borrower and Guarantors, (b) payment of an amendment fee in the amount of $5,000
and (c)  payment  of all fees  and  expenses  (including  attorneys'  fees)  and
out-of-pocket  expenses of the Lender that are due and payable from the Borrower
to the  Lender  in  accordance  with  Section  10.04  of the  Credit  Agreement,
including but not limited to all such amounts  incurred in connection  with this
Amendment.

     3.  Representations and Warranties.  The Borrower and each Guarantor hereby
confirms, reaffirms and restates the representations and warranties set forth in
Section 5 of the Credit Agreement,  as amended by this Amendment.  To induce the
Lender  to  enter  into  this   Amendment,   the  Borrower  and  each  Guarantor
individually and collectively represents and warrants that:

          (a) After  giving  effect to this  Amendment,  no  Default or Event of
     Default has occurred and is continuing.

          (b)  The  total  amount  of all  fees  paid by  Borrower,  Guarantors,
     Subsidiaries or their Affiliates,  including but not limited to PrimeSource
     Surgical Inc., to Citizens Bank of Massachusetts ("CITIZENS") in connection
     with a certain waiver and amendment  letter from  Citizens,  dated June 28,
     2001 (the "CITIZENS WAIVER"), regarding certain Events of Default under the
     Amended  and  Restated  Credit  Agreement  dated June 14, 1999 by and among
     PrimeSource Surgical,  Inc., Bimeco, Inc., Medial Companies Alliance, Inc.,
     Douglas  Medical Inc. and State Street Bank and Trust Company,  as amended,
     does not exceed  $10,000 and Borrower,  Guarantors,  Subsidiaries  or their
     Affiliates will not make any additional payments on account of the Citizens
     Waiver.

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<PAGE>
          (c) An  Alternative  Equity  Financing  (as defined in the  Borrower's
     Certificate of Designation of Series D Exchangeable  Preferred  Stock) took
     place on June 29, 2001 pursuant to which Borrower issued Series E Preferred
     Stock which has a conversion price of $1.00 per share.

          (d) Except for Permitted Liens, Lender has valid,  continuing and duly
     perfected first and prior liens on and first priority  security interest in
     the Collateral.

     4.  Continuing  Effect of the Credit  Agreement.  This Amendment  shall not
constitute an amendment or any  provision of the Credit  Agreement not expressly
referred  to herein  and shall not be  construed  as a waiver or  consent to any
further or future action on the part of the Borrower that would require a waiver
or consent of the Lender.  Except as expressly  amended  hereby,  all the terms,
provisions and conditions of the Credit Agreement are and shall remain unchanged
and shall continue in full force and effect.

     5.  Counterparts.   This  Amendment  may  be  executed  in  any  number  of
counterparts, each of which when so executed and delivered shall be an original,
but all of which shall  constitute one and the same  instrument.  Delivery of an
executed  counterpart  of this  Amendment  by telecopy  shall be effective as an
original and shall constitute a representation  that an executed  original shall
be delivered.

     6.  GOVERNING  LAW. THIS  AMENDMENT AND THE RIGHTS AND  OBLIGATIONS  OF THE
PARTIES  HEREUNDER  SHALL  BE  GOVERNED  BY AND  CONSTRUED  AND  INTERPRETED  IN
ACCORDANCE WITH THE LAWS OF THE STATE OF NEW YORK.



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<PAGE>

     Each of the parties hereto has caused a counterpart of this Amendment to be
duly executed and delivered as of the date first above written.



BORROWER:                            PRIMESOURCE HEALTHCARE, INC.,
--------                             f/k/a LUXTEC CORPORATION

                                       a Massachusetts corporation


                                     By:  /s/ Michael K. Bayley
                                     -------------------------------------------
                                            Name:   Michael K. Bayley
                                            Title:  Executive Vice President and
                                                    Chief Financial Officer


GUARANTORS:                          FIBER IMAGING TECHNOLOGIES, INC.,
----------
                                       a Massachusetts corporation


                                     By:  /s/ Sam Stein
                                     -------------------------------------------
                                            Name:   Sam Stein
                                            Title:  Vice President and
                                                    General Manager

                                     CATHTEC INCORPORATED,
                                     a Massachusetts corporation


                                     By:  /s/ Sam Stein
                                     -------------------------------------------
                                            Name:   Sam Stein
                                            Title:  Vice President and
                                                    General Manager


                                     CARDIODYNE, INC.,
                                       a Massachusetts corporation


                                     By:  /s/ Sam Stein
                                     -------------------------------------------
                                            Name:   Sam Stein
                                            Title:  Vice President and
                                                    General Manager


LENDER:                              ARK CLO 2000-1, LIMITED
------

                                     By:      Patriarch Partners, LLC,
                                              its Collateral Manager


                                     By:  /s/ Lynn Tilton
                                     -------------------------------------------
                                            Name:   Lynn Tilton
                                            Title:  Manager


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