Despite a less-than-perfect history of growth, margins and returns on equity, IntegraLifeSciences (NASDAQ:IART) has managed to maintain investor interest and support for some time. This is partly due to a history of reliable management guidance and performance. But with a first-quarter miss and some slightly disappointing guidance, investors seem to have lost a bit of faith, sending the shares down more than 15% at one point during Monday trading.

First-quarter results missed the Wall Street median on both the top and bottom line. That's not to say the company's performance was necessarily bad. Revenue rose 26% and operating income also managed to eke out double-digit growth.

Acquisitions have always been a major component of Integra, and the first quarter was no different. While product revenue grew 28% for the quarter, management reported their organic growth at about 10%.

Margins were also problematic in the quarter. Gross margins improved by about 1%, but some of the company's recent acquisitions drove SG&A up by about 4% as a percentage of sales. At the operating level, then, Integra achieved a margin of 19.7% vs. 22.4% in the year-ago period.

Integra management offered guidance with midpoints below prior analyst expectations, but still upheld their long-term target of 18% organic growth. While that growth rate isn't out of line for a quality med-tech company, investors shouldn't forget that competitors like Medtronic (NYSE:MDT), Johnson & Johnson (NYSE:JNJ), and Tyco (NYSE:TYC) are very much in the game as well.

Analyzing Integra can be tricky. While some metrics are strong -- the company has good revenue growth and is improving operating cash flow -- the stock isn't a slam dunk. The company's margins and return on equity aren't that great, and valuation (whether on a P/E or cash-flow basis) doesn't appear to be a bargain. What's more, the company's ongoing reliance on acquisitions may tie up company resources; it also raises the potential for eventual bad acquisitions.

Still, Integra has undeniable appeal. Neurology (a primary focus for the company) remains a hot space in the med-tech world. Furthermore, the company has what many med-tech companies do not: a demonstrated history of competitive successes.

Having once owned the stock a while back, I'm not all that keen on piling in today. I'm focusing my attention on stocks with better valuations and better metrics right now. Still, if management can achieve their target of 18% internal growth, this stock should reward its more patient owners.

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Fool contributor Stephen Simpson owns shares of Johnson & Johnson. The Fool has a disclosure policy.