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in OZ we group our instruments together with ?? instrument clips, a bit like really large safety pins... we must buy them from the companies that sell instruments I guess .. we do not use rubber bands for anything (latex allergies of course). instruments can be grouped and sterilised together with these clips.
we use instrument pins for items such as crile roberts etc that come as extras from HSDU these are grouped in 5's or 10's. Langenbecks or retaining instruments are packed in 1' or 2's but never held with elastic bands or pins. Extras are accounted for on the swab board as extras as well as the HSDU packet being retained for return purposes and tracking. Does this help?