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Within the last decade there has been a shift away from the traditional on-call model towards an Acute Surgical Unit (ASU) model for managing patients who present with acute general surgical conditions. This shift has been driven by results from multiple studies showing improved clinical and non-clinical outcomes with the ASU model of care. Nepean Hospital is a large tertiary referral centre in Western Sydney. The hospital adopted the ASU model in November 2006 and since then the consultant driven, protocol based model has been used for patients presenting with a wide variety of general surgical problems. To date there has been no analysis of appendicectomy outcomes for patients presenting to Nepean Hospital with acute appendicitis. Furthermore there is a paucity of evidence in the literature looking at whether or not ‘established’ ASU departments maintain positive outcomes, with the majority of studies comparing the period immediately before and after implementation of the ASU model. Over time, factors such as increasing workload, staffing and theatre access may limit the effectiveness of the ASU model. It is therefore important to evaluate how the ASU model has functioned over time. Four papers are presented within this thesis by publication. The first two papers specifically assess outcomes for patients who underwent an appendicectomy for suspected acute appendicitis treated within ‘pre’, ‘early’ and ‘established’ ASU groups. These papers demonstrate many of the improvements in clinical and non-clinical outcomes for patients treated in the ‘established’ ASU. Results from these papers did reveal a gradual increase in the rate of negative appendicectomy; this issue is addressed in detail in paper three. Finally, paper four specifically focuses on the ASU's use of laparoscopic washout as a novel approach for managing persistent sepsis or collections following appendicectomy.