Firstly, assess the damage and administer whatever sedative we have on hand. Morphine-Everclear.

Secondly, Determine how bones are separated and if there are any fragments. Looks to me like the big toe is a loss and fragmented but just shaved the metatarsal of his large toe on the inboard side.

Thirdly, clean the wound and remove the big toe bone fragments as it looks like it was broken. I would remove both sides of big toe and enough muscle to perform a combat amputation without the complication of sawing any protruding bone.

Fourth, CLEAN AGAIN AND AGAIN

Fifth, Suture and fold over skin from big toe to cover metatarsal. Ensure use of disposable sutures with no rolling of skin to allow the wound to drain as it has to heal from deeper inside.

Sixth, Immobilize leg with no walking

Seventh, Monitor 2x daily for heat, excess drainage, discoloring or any other sign of infection. If infected, any of the -illins would be my go to from the fish department. Otherwise simply some colloidal silver and whatever pain management we can do.

Eight, Only reopen to reclean if absolutely essential.