Thanks to Sal's comment, I think I was able to find a reasonably complete solution to my question. I'm sharing a summary, that I've put together based on this paper on Trinomial test, which I definitely recommend.
Note that $B(x,n,p)$ is binomial test for x successes and n trials with probability p.
$N_+$ is the number of positives signs, $N_-$ is the number of negative signs, and $N_0$ is the number of ties.
History of treatment of ties in the sign test:
Dixon and Mood (1946): include half the number of ties to positive observations as a nonrandomized unconditional exact test ($B(N_+ + N_0/2, N, 1/2)$)
Dixon and Massey (1951) -- most popular: exclude ties $B(N_+, N - N_0, 1/2)$
Putter (1955): asymptotic uniformly most powerful nonrandomized test which uses:
$S_{1/2} = \frac{N_+ - N_-}{\sqrt{N_+ + N_-}}$
Rejects the null hypothesis if $S_{1/2}$ is greater the the $100(1-\alpha)th$ percentile of a standard normal distribution. $N$ must be large.
Coakley and Heise (1996): Improved nonrandomized unconditional test:
$S_{2/3} = N_+ + 2N_0/3$
where the null hypothesis is rejected if $S_{2/3} > \kappa (p_0)$. Disclosure: "I don't know what $\kappa$ means here, the paper doesn't mention, but I'm including it for the sake of being thorough".
Finally, and most importantly, according to Wittkowski (1989): If ties are due to the nature of the phenomenon, which is true in my case, they will not give valuable information. Therefore, I think they can be ignored. However, if they're due to rounding errors, their inclusion should be considered.
References
- Dixon, W.J. and Mood, A.M. (1946). The Statistical Sign Test. Journal of the
American Statistical Association 41, 557-566.
- Dixon, W.J. and Massey, F.J.Jr. (1951). An Introduction to Statistical Analysis. New York: McGraw-Hill.
- Putter, J. (1955). The Treatment of Ties in Some Nonparametric Tests. Annals
of Math. Stat. 26, 368-386.
- Coakley, C.W. and Heise, M.A. (1996). Versions of the Sign Test in the Presence of Ties. Biometrics 52(4), 1242-1251.
- Wittkowski, K.M. (1989). An Asymptotic UMP Sign Test for Discretised Data.
The Statistician 38, 93-96.