Hospitalisation and wound care
Figure 2 . Sterile environment suitable for open wound .
face ( Figure 3 ). Surgical closure of the wound would allow the addition of loose substrate and a more natural environment to be provided . Rapid release is always a priority in wildlife [ 14 ] , but particularly so for this case , as winter was approaching and the toad needed to prepare for brumation . Repeat anaesthesia was performed ; the bone was shortened and the skin was sutured in place around it using 3 – 0 polydioxanone suture .
Figure 3 . Abrasions above both eyes .
The Wildlife Requirements Model ( an adaptation of the Ability Model [ 14 ] ) was used as a basis for the toad ' s hospitalisation and nursing care . Effort was made to replicate the toad ' s natural environment to allow normal behaviours and prevent stress while in captivity . Toads usually burrow under bark and rocks during the day for safety [ 1 ] , but this was not favoured during the immediate postoperative period due to the risk of wound contamination . To maintain a clean environment and facilitate the close monitoring of wound healing , loose substrate was substituted for moist paper towels ( Figure 2 ). Hides were provided so the toad could exhibit normal burrowing behaviours and to reduce stress [ 14 ] .
The progression of the wound following the first and second closure surgeries can be seen in Figure 4 . Wound barrier ointment ( Orabase , Convatec ) protected the wound when open after breakdown . Care should be taken using these and similar plasticised hydrocarbon pastes as some contain benzocaine , which can cause sedation or fatality when absorbed systemically [ 10 ] . Silver sulfadiazine is another ointment that can be used for amphibian wounds [ 9 , 10 ] . The wound received light therapy ( Photizo , Photon Therapy Systems Ltd ) daily for the first 7 days . Handling for light therapy coincided with medication administration , and efforts were made to handle the toad only during hours when it would naturally be awake , to limit stress [ 3 ] .
The outside temperature was too low ( below 5 ° C ) for the toad to be released prior to winter , so overwintering advice was sought from the Amphibian and Reptile Conservation Trust ( ARC ). Once the wound had mostly closed and was healing well , the enclosure was changed
Figure 4 . Progression of wound healing : 1 . Presentation of degloving injury with foot amputation . 2 . Wound breakdown with suture rejection . 3 . Open wound with bone very close to the surface . 4 . Following revision surgery . 5 . Continued healing . 6 . Closure .
56 Veterinary Nursing Journal